In short: The main travel hubs are at moderate altitude: Guatemala City about 1,510 m, Antigua about 1,580 m, the Lake Atitlán towns about 1,580-1,690 m. Quetzaltenango (Xela) is about 2,350 m, and Totonicapán and Todos Santos Cuchumatán about 2,500 m. The CDC Yellow Book puts the line at a sleeping altitude of 2,450 m (8,000 ft): above it, any unacclimatized traveller is at risk of altitude illness, and sometimes lower. What crosses it: the volcano summits (Acatenango 3,976 m, Tajumulco 4,220 m, Santa María 3,772 m and others), especially on trips that camp on the mountain, and the highest highland towns. Tikal, Flores, Lanquín, Río Dulce and the Pacific beaches are low.
This page gives one number per place and sets it against the CDC’s thresholds. It is not medical advice and does not cover medication or dosing: for that, see a doctor or travel clinic. For the hikes themselves, see our Acatenango and Tajumulco guides.
The CDC lines that matter
All from the CDC Yellow Book chapter High-Altitude Travel and Altitude Illness (read 25 September 2026):
| CDC threshold | What the CDC says |
|---|---|
| 2,450 m (8,000 ft) sleeping altitude | Any unacclimatized traveller sleeping at or above this height, “and sometimes lower”, is at risk for altitude illness. |
| 2,750 m (9,000 ft) in one day | Avoid going directly from low altitude (below 1,200 m / 4,000 ft) to a sleeping altitude above 2,750 m in one day. |
| Above 3,000 m (9,850 ft) | Move sleeping altitude by no more than 500 m (1,600 ft) per day, with an extra day of acclimatization for every additional 1,000 m. |
| Day trips | Day trips to high altitude with an evening return to a lower altitude are much less stressful on the body. |
| Descent | Acute mountain sickness improves rapidly with a descent of 300 m (1,000 ft) or more. |
| Colorado benchmark | Acute mountain sickness affects 25% of all visitors sleeping above 2,450 m (8,000 ft) in Colorado. |
The CDC also notes that fitness and training do not affect the risk, and that children are as susceptible as adults.
Elevation of Guatemala’s travel hubs
Town elevations are the digital elevation model value (SRTM3 or GTOPO30, as served by GeoNames) at each town’s point in the GeoNames gazetteer: an average over roughly a 90 m square (SRTM3) or a 900 m square (GTOPO30), rounded here to the nearest 10 m except below 10 m. A town centre on a slope spans tens of metres, so treat each as approximate.
| Place | Elevation (m) | Elevation (ft) | Against the CDC 2,450 m sleeping line |
|---|---|---|---|
| Río Dulce | ~7 | ~23 | Far below |
| Monterrico (Pacific) | ~10 | ~33 | Far below |
| Flores | ~120 | ~400 | Far below |
| Tikal | ~240 | ~790 | Far below |
| Retalhuleu | ~240 | ~790 | Far below |
| Lanquín | ~350 | ~1,150 | Far below |
| Cobán | ~1,330 | ~4,350 | Below |
| Guatemala City | ~1,510 | ~4,950 | Below |
| Antigua Guatemala | ~1,580 | ~5,190 | Below |
| Panajachel | ~1,580 | ~5,190 | Below |
| San Marcos La Laguna | ~1,590 | ~5,200 | Below |
| San Pedro La Laguna | ~1,590 | ~5,220 | Below |
| Santiago Atitlán | ~1,600 | ~5,260 | Below |
| San Juan La Laguna | ~1,610 | ~5,270 | Below |
| Santa Cruz La Laguna | ~1,690 | ~5,530 | Below |
| Huehuetenango | ~1,910 | ~6,260 | Below |
| Nebaj | ~1,910 | ~6,260 | Below |
| Sololá | ~2,040 | ~6,710 | Below |
| Chichicastenango | ~2,080 | ~6,810 | Below |
| Comalapa | ~2,120 | ~6,940 | Below |
| Tecpán | ~2,290 | ~7,520 | Just below |
| Quetzaltenango (Xela) | ~2,350 | ~7,710 | Just below |
| Totonicapán | ~2,500 | ~8,200 | At or just above |
| Todos Santos Cuchumatán | ~2,500 | ~8,200 | At or just above |
A reader flying into Guatemala City lands at about 1,510 m, already above the CDC’s 1,200 m “low altitude” starting point used in its one-day rule.
Volcano summits
Summit heights are the GeoNames “elevation” field for each volcano (the satellite dem value there is lower, because it averages the summit with the slopes around it), except Agua, where we use the Ministerio de Cultura y Deportes’ figure of 3,766 m; GeoNames gives 3,760 m.
| Volcano | Summit (m) | Summit (ft) | Our guide |
|---|---|---|---|
| Pacaya | 2,552 | 8,373 | Pacaya |
| San Pedro (Lake Atitlán) | 3,020 | 9,908 | San Pedro volcano |
| Tolimán | 3,158 | 10,361 | — |
| Atitlán | 3,535 | 11,598 | — |
| Agua | 3,766 | 12,356 | Volcán de Agua |
| Fuego | 3,763 | 12,346 | Fuego status |
| Santa María (near Xela) | 3,772 | 12,375 | Santa María |
| Acatenango | 3,976 | 13,045 | Acatenango |
| Tajumulco | 4,220 | 13,845 | Tajumulco |
How the CDC lines apply:
- Up and back in a day: the CDC says a day trip to high altitude with an evening return to a lower altitude is much less stressful on the body than sleeping high.
- Sleeping on the mountain: our Acatenango and Tajumulco guides describe trips that camp on the mountain, below summits of 3,976 m and 4,220 m. Operators publish their own camp heights; we have not verified one, so ask yours and compare it with the 2,450 m and 2,750 m lines.
- Staging. The CDC’s own example of a protective step is spending at least 2-3 nights at about 2,450-2,750 m before going higher. Antigua (about 1,580 m) and Xela (about 2,350 m) are both below that band.
Symptoms and what the CDC says to do
- Symptoms (acute mountain sickness): the CDC says they are like those of an alcohol hangover, and that headache, the cardinal symptom, usually comes with one or more of loss of appetite, dizziness, fatigue, nausea or, occasionally, vomiting.
- Timing: the CDC says onset is usually 2-12 hours after arriving at altitude or after climbing higher, often during or after the first night, and that it generally resolves within 12-48 hours if you do not climb higher.
- Descent: improves rapidly with a descent of 300 m (1,000 ft) or more. If symptoms get worse at the same altitude despite treatment, the CDC says descent is mandatory.
- Other hazards on the same summits: the UK Foreign Office warns that some Guatemalan volcanoes have freezing night temperatures and that there is no mountain rescue service; the US State Department advises hiking volcanoes only with a qualified local guide.
Related
- Hiking volcanoes in Guatemala
- Acatenango overnight hike
- Best time to visit Guatemala, month by month
- Vaccines and health requirements for Guatemala
Sources
- CDC Yellow Book — High-Altitude Travel and Altitude Illness (US federal, public domain): https://www.cdc.gov/yellow-book/hcp/environmental-hazards-risks/high-altitude-travel-and-altitude-illness.html — read 2026-09-25.
- Ministerio de Cultura y Deportes, Sistema de Información Cultural — Volcán de Agua (3,766 m): https://www.sicultura.gob.gt/directory-directorio_c/listing/volcan-de-agua/ — read 2026-09-24.
- GeoNames gazetteer, Guatemala extract (licence CC BY 4.0; the
demfield is SRTM3 or GTOPO30, SRTM processed by CGIAR-CSI): https://download.geonames.org/export/dump/GT.zip — downloaded 2026-09-25. - UK Foreign, Commonwealth & Development Office — Guatemala: Safety and security (climbing volcanoes): https://www.gov.uk/foreign-travel-advice/guatemala/safety-and-security — read 2026-09-24.
- US Department of State — Guatemala Travel Advisory: https://travel.state.gov/en/international-travel/travel-advisories/guatemala.html — read 2026-09-24.
Contains GeoNames data (geonames.org), CC BY 4.0. This page is information, not medical advice. Information current as of 25 September 2026.
Frequently Asked Questions
Is Guatemala high altitude?
Parts of it. Guatemala City (about 1,510 m), Antigua (about 1,580 m) and the Lake Atitlán towns (about 1,580-1,690 m) are moderate altitude. Quetzaltenango (about 2,350 m), Totonicapán and Todos Santos Cuchumatán (about 2,500 m) are higher. Flores, Tikal, Lanquín, Río Dulce and the Pacific beaches are near sea level or low. The volcano summits run from Pacaya (2,552 m) to Tajumulco (4,220 m). Town figures are satellite elevation-model values at the GeoNames gazetteer point for each town.
Can you get altitude sickness in Antigua Guatemala?
Antigua sits at about 1,580 m, below the 2,450 m sleeping altitude at which the CDC Yellow Book says any unacclimatized traveller is at risk of altitude illness. The CDC adds that risk exists sometimes lower, so the line is a guide, not a guarantee. Antigua is the usual base for the Acatenango hike, which goes far higher.
Can you get altitude sickness on Acatenango?
Yes, it is possible. Acatenango’s summit is 3,976 m, and the trip described in our Acatenango guide camps overnight on the mountain. The CDC Yellow Book says anyone sleeping at 2,450 m or higher without acclimatization is at risk, that symptoms usually start 2 to 12 hours after arrival at altitude, and that descending 300 m or more improves acute mountain sickness. Ask your operator for the camp’s elevation.
What are the symptoms of altitude sickness?
According to the CDC Yellow Book, acute mountain sickness feels like an alcohol hangover: headache is the main symptom, usually with one or more of loss of appetite, dizziness, fatigue, nausea or, occasionally, vomiting. The CDC says onset is usually 2 to 12 hours after arriving at altitude, often during or after the first night. It improves rapidly with descent of 300 m (1,000 ft) or more.
Should I take altitude sickness pills for Guatemala?
That is a question for a doctor or travel clinic before you go. The CDC Yellow Book’s guidance on preventive medication is written for healthcare professionals and depends on the sleeping altitude and how fast you climb. We do not give dosing advice.
