Where the air gets thin and the views get long
8 Highest-Altitude Cities in the World
From a Peruvian gold-mining town above 5,000 m to the official capitals of Bolivia and Ecuador, these are the highest permanently inhabited cities on Earth.
Above 2,500 m the body starts producing more red blood cells; above 4,000 m most visitors feel altitude sickness within hours. The residents of these eight cities live their entire lives at elevations that send the rest of us to bed with a headache.
How we chose these ↓ — jump to the full scoring system at the bottom of the article.
Mexico City, Mexico · pop. 9,209,944
Often forgotten on altitude lists, Mexico City sits at roughly 2,240 m in the Valley of Mexico, easily making it the highest megacity in North America and one of the highest in the world. The Aztec capital Tenochtitlán originally occupied a lake bed here; the modern city's persistent sinking is a direct legacy of draining that lake.
The altitude has real consequences. Endurance athletes train here for high-altitude races, the 1968 Olympics produced a string of long-jump and sprint records, and visitors flying in from sea level are routinely advised to skip the mezcal on the first night. See also our list of the world's largest megacities for more on how the basin holds 22 million people.
Cusco, Peru · pop. 428,450
Cuzco, the historic Inca capital at roughly 3,400 m, is the staging ground for almost every trip to Machu Picchu and one of the most-visited high-altitude cities on Earth. The Spanish built their colonial baroque churches directly on top of Inca stonework, producing a layered cityscape that UNESCO recognised in 1983.
The city's tourism economy is so large that Peru's Ministry of Culture caps daily entries to Machu Picchu to limit damage; Cuzco itself acts as the air-lock. Most arriving travellers spend a day or two acclimatising before climbing higher, and locals brew muña and coca tea by the litre to help.
Pichincha, Ecuador · pop. 2,671,191
At 2,850 m, Quito is the highest official national capital in the world (La Paz is the higher seat of government but not the constitutional capital). Its historic centre, sitting in a long valley below the Pichincha volcano, was one of the first two sites ever inscribed by UNESCO in 1978.
The old town's Spanish baroque churches, including La Compañía de Jesús with its gilded interior, are some of the best-preserved colonial architecture in the Americas. The TelefériQo cable car climbs another 1,100 m above the city to a viewpoint at almost 4,000 m, where the altitude is enough to make visitors short of breath on the steps.
Tibet, China · pop. 564,651
Tibet's capital sits at 3,656 m on a tributary of the Yarlung Tsangpo, dominated by the Potala Palace, the former seat of the Dalai Lamas and a UNESCO World Heritage site since 1994. Centuries of Himalayan caravan trade gave Lhasa an outsized cultural footprint relative to its population.
The Qinghai-Tibet Railway, opened in 2006, was a feat of high-altitude engineering: oxygen is piped into passenger cabins as trains cross the 5,072 m Tanggula Pass on the way in. The journey has reshaped the city's economy, and Lhasa now sees more domestic Chinese tourists than international ones.
Bolivia, Bolivia · pop. 154
Bolivia's seat of government tumbles down a canyon between roughly 3,200 m and 4,100 m, which makes it the highest capital city in the world by almost any reasonable measure. Wealthier neighbourhoods cluster in the warmer, lower Zona Sur; the working-class districts climb the canyon walls.
La Paz shares administrative duties with Sucre, the constitutional capital, but it holds the executive branch, the central bank and the airport (El Alto International, at 4,061 m, one of the highest commercial airports in the world). Visitors are routinely warned about soroche, and coca tea is served on arrival in most hotels.
Bolivia, Bolivia · pop. 198,397
Potosí sits at 4,090 m on the slopes of Cerro Rico, the silver mountain that funded the Spanish Empire for two centuries. At its peak in 1650 it was one of the largest and richest cities in the world, with more inhabitants than contemporary London or Paris.
UNESCO inscribed the historic city in 1987 and added it to the World Heritage in Danger list in 2014 as the mountain itself slowly collapses from centuries of tunnelling. Tens of thousands still mine the same shafts in conditions described by the International Labour Organization as some of the most hazardous on Earth.
Bolivia, Bolivia · pop. 846,880
Sitting on the canyon rim above La Paz at roughly 4,150 m, El Alto has exploded from a suburb of a few thousand into Bolivia's second-largest city, with over a million residents. It is now the highest large city on Earth and a powerhouse of indigenous Aymara political and commercial life.
Its cable-car system, Mi Teleférico, is the longest urban gondola network in the world precisely because building a metro at this altitude on a canyon edge is impossible. The city's architecture has produced its own style, the cholet, neo-Andean towers by architect Freddy Mamani that have become a global design reference point.
Áncash, Peru · pop. 2,648
Often cited as the highest permanent settlement on Earth at roughly 5,100 m, La Rinconada is a gold-mining town hanging off a glacier in the Peruvian Andes. Roughly 50,000 people live without running water, sewage or municipal heating, breathing roughly half the oxygen available at sea level.
Life expectancy is well below the national average and chronic mountain sickness is endemic, yet new arrivals keep coming for the informal cachorreo gold-payment system. Researchers including the high-altitude physiology team at Universidad Peruana Cayetano Heredia treat the town as a living laboratory for the upper limit of permanent human habitation.
How we chose these
We selected cities by mean elevation above sea level using national statistics offices and, where possible, peer-reviewed sources on permanent human settlement (Peruvian, Bolivian and Chinese national geographic agencies; UNESCO; the International Society for Mountain Medicine). Temporary scientific stations, seasonal mining camps and military outposts are excluded; the focus is on places with year-round civilian populations, public services and continuous habitation. La Rinconada is on the edge of that definition and we note that explicitly.
Sources & further reading
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For entertainment only. Rankings on this page are editorial picks compiled from public sources for fun and discovery — they aren't a scientific measurement. Population figures and place details come from open data; see the linked place pages for sources.