Here is the part travel influencers skip: altitude sickness at 3,400 meters is not a minor inconvenience. It is a genuine medical risk. The experience documented in the r/travel thread — stomach cramps severe enough to require hospitalisation for IV fluids and severe dehydration — is a common enough outcome that it warrants direct discussion.

Cusco sits higher than almost any capital city in Europe or North America. The standard acclimatisation advice — arrive slowly, rest the first day, avoid alcohol, drink coca tea — exists for good reason. Most travelers who end up in hospital did not follow it. Altitude sickness can present deceptively: what begins as mild headache and breathlessness can escalate rapidly to pulmonary or cerebral edema in severe cases.

Travel health experts consistently recommend:

- Spending at least 48-72 hours in Cusco before any strenuous activity - Arriving from a lower-altitude city like Lima where possible - Avoiding alcohol entirely for the first two days - Knowing the nearest medical facilities and carrying altitude medication (acetazolamide) if advised by a doctor before travel - Descending immediately if symptoms worsen — altitude sickness does not improve by pushing through

What February actually looks like on the ground

The Inca Trail closes in February for maintenance and ecological recovery. This means the iconic 4-day trek to Machu Picchu is unavailable, but alternative routes — the Salkantay Trek, the Lares Trek, and train options — remain open. Machu Picchu itself stays open year-round.

The traveler who shared the account described Cusco as "a lot bigger than I expected, cleaner and more beautiful" and felt completely safe even with a camera out at night. The Sacred Valley delivered hikes with zero crowd pressure — a rarity in one of South America's most-visited corridors.

The verdict from experienced travelers: Peru in February is a genuine bargain with genuinely extraordinary landscapes. But arrive with time, arrive with humility about the altitude, and acclimatise properly before you do anything strenuous.