Health and safety

Altitude sickness can affect anyone, regardless of their experience or fitness level. We insist on designing an itinerary that allows enough time for you to acclimatise during your trek. There’s a safe limit that we can ascend daily. So, some trekking days will be shorter than others.

We recommend that you read our complete guide to altitude sickness when trekking Nepal, but at the very least you need to know and remember the symptoms listed here.

Common symptoms to remember and look out for include:

  • Headache
  • Nausea and vomiting
  • Dizziness
  • Tiredness
  • Loss of appetite
  • Shortness of breath

If you show any signs of altitude sickness when trekking Nepal, for your own safety we’ll take immediate action to descend quickly. This is the most effective treatment in the absence of a medical facility. You must talk to your guide or porter immediately if you’re feeling unwell.

Some longer treks have rest days built in. Don’t worry – we’ll still trek to some stunning places and vantage points! But we’ll return to sleep in the same place. This will help you to acclimatise to the high altitude.

There are things that you can do to take care of yourself during your trek. It helps if you drink a lot of water and avoid alcohol, especially at high altitudes.

Altitude Sickness Medication

Medication exists called Acetazolamide, commonly known by its trade name Diamox. It’s used for the treatment and prevention of altitude sickness. We’re unable to provide this, as it’s a prescription medicine. If you’re interested in taking this medication, either as a preventative or in the event of altitude sickness symptoms, please speak with your doctor or medical professional before you leave home.

For more information about altitude sickness when trekking Nepal, don’t forget to read our complete guide or you can visit this website.

Seek Advice From Your Medical Professional

When you travel to any foreign country, you need to be aware of the health risks. We recommend that you visit your doctor or health professional at least four to six weeks before you fly, to discuss the health risks in Nepal. They’ll let you know if you need any vaccinations or other preventative measures (including for altitude sickness).

In some countries you can find a ‘Travel Doctor’ with special knowledge about health risks when traveling. It’s also worth checking your own Government’s foreign travel advice about travelling to Nepal.

Seek advice about what to take in your first aid kit and keep in mind that food poisoning can occur. So, it’s likely you’ll want something for that! Ice in a drink is often the culprit, so avoid it unless you’re fully confident that it’s safe to drink.

Your health and safety is our top priority, so we’ll do all we can to take great care of you!

Altitude Sickness

Altitude sickness can affect anyone, regardless of their experience or fitness level. We insist on designing an itinerary that allows enough time for you to acclimatise during your trek. There is a safe limit that we can ascend daily. So, some trekking days will be shorter than others.

It’s important to know the symptoms of altitude sickness so you know what to look out for. It’s also possible to speak to your medical professional about preventative medication. Find more information about altitude sickness in our Complete Guide.

Travel Insurance

Medical treatment is expensive, and scarce in remote areas of Nepal. Trekking can be very challenging and there are several health risks in Nepal that could affect you. That’s why we strongly recommend that you purchase comprehensive travel insurance to cover your trip. Trekking in Nepal can be dangerous, especially at high altitudes. We need to be sure that in the event of an emergency, we can take action quickly. Find more information about travel insurance in this FAQ.

Disaster Struck Nepal in April 2015

You may have some concerns about doing a trek in Nepal after the earthquake in 2015. You’d be right, because Nepal is in a major earthquake zone. In April 2015, a huge earthquake struck and nearly 9,000 people were killed. Our Co-Founder Krishna lost his home as well as hundreds of thousands of Nepalis. Krishna felt many large aftershocks. In fact, his family slept in a field under canvas for many months after, for fear of another large earthquake. Needless to say, it was unsafe to trek in many areas of Nepal for at least one year after.

The avalanche site in Langtang - Trekking after the Nepal Earthquake
The avalanche site in Langtang

Some of the popular trekking trails including the Annapurna Circuit and Annapurna Base Camp weren’t affected by the earthquake. Those mainly affected were in the Everest and Manaslu regions, and most significantly in the Langtang region of Nepal. Langtang village was completely destroyed by a massive landslide. 243 people lost their lives including 41 foreign trekkers.


Today, you’ll find everything is back to normal in Nepal. Trekking after the Nepal earthquake is much the same as before. Although you’ll still see ruins and debris left over from the earthquake and some trails have been diverted.

All the trekking trails are open and thriving. Langtang village has been completely rebuilt further along the trail. We trekked in the Langtang Valley in January 2018. You can read our blog to find out what it’s like after the earthquake.

Nepal is in a Major Earthquake Zone

It’s important for you to understand that Nepal is in a major earthquake zone. The country remains at risk from earthquakes. Your safety is our top priority and our guide will instruct you in the event of an earthquake.

For your own safety, we strongly recommend that you purchase comprehensive travel insurance for trekking Nepal. Your policy should cover your trek and any extra time you’re planning to spend in Nepal. Trekking Nepal can be dangerous, especially at high altitudes. So, we want to be able to act fast in the event of an emergency. If you’ve purchased suitable travel insurance for trekking, it’s easy to request fast emergency assistance. We’ll ask for your insurance and emergency contact details before you leave home.

Travel Insurance for Trekking Nepal to Include Helicopter Evacuation

Your policy needs to include helicopter evacuation above the highest altitude on your trek (e.g. above 4,130m/13,550ft for Annapurna Base Camp). Some people need to be airlifted out of the Himalaya mountains. Either because of altitude sickness, or an injury. Even with a sprained ankle, it’s unlikely you’ll be able to complete your trek. So, it’s simply not worth the risk to trek in Nepal without travel insurance.

Increasing Premiums

Travel insurance providers around the world have been hit with an extremely high number of claims in Nepal. It is alleged that some local businesses act fraudulently to profit from unnecessary helicopter evacuations. As a result, premiums have increased to cover the cost of claims. You can read more in this article.

We’ve always purchased this insurance policy with World Nomads. However, they’ve also had to increase their premiums recently. So, we recommend that you shop around for the most reasonable policy. But please make sure that it covers helicopter evacuation – yours could be a real emergency.

Naturally, it’s your responsibility to ensure the policy you buy covers all your requirements. Also, that you follow the requirements of your insurance provider when making a claim.

Trekking Nepal is a big deal! You put your complete trust in a stranger to guide you in the mighty Himalaya. Not a decision to be taken lightly. If you trek with a guide that isn’t very good, or that you don’t get along with, it could ruin your trip. That’s why it’s critical for you to trek with a trustworthy Nepal trekking guide.

We’ve been there and we understand how important it is to have the very best possible trekking guide. Your guide needs to speak good English, be very experienced, knowledgeable and friendly. But if he’s no fun to be around, your trip won’t be the same!

That’s why Krishna carefully selects all our guides himself.

“I choose the very best guides who are just like me! They all have lots of experience trekking all over Nepal. They are very professional, but they are also very kind, friendly people.” Krishna – Managing Director, Nepalorama Trekking

We know our clients love Krishna, they’ve said so in many client reviews on our website and on Tripadvisor! So, thanks to him, we know what makes an excellent trekking guide, and we make sure all our guides tick these boxes!

Krishna has known all our guides for many years. In fact one of our guides Ramesh is Krishna’s brother! Krishna has trekked with each and every one of our guides, so he knows exactly how they operate. For us, service is everything. Both before and during your trek. It’s really important that your guide provides great service, as well as being experienced, knowledgeable and fun!

How do we Choose a Guide for Your Trek?

We consider the average age of the people trekking. All our guides are wonderful, but sometimes a younger group may prefer to trek with a younger guide. Likewise an older group may prefer an older guide!

It’s important to make sure your guide knows your trekking route intimately. Some guides have spent more time guiding treks in particular regions than others. So, we select a guide who knows your trek and the business owners along the trail exceptionally well!

Our Commitment to You

We guarantee that with us, you’ll trek with a trustworthy Nepal trekking guide and be in the safest hands. Your guide will do everything possible to make sure you have an amazing, authentic experience in Nepal.

Meet our Nepalorama Guides!

Read our Nepal trekking guide interviews with Krishna, Bibek, Ramesh and Buddhi. More interviews coming soon!