Peru is the itinerary most travellers get wrong by flying directly to Cusco (altitude 3,400m) and getting altitude sickness on day one. The right pattern: land Lima at sea level, spend three nights eating (Central, Maido, Astrid y Gastón — Lima has three of the World's 50 Best Restaurants), fly to Cusco and transfer straight down to the Sacred Valley (2,800m) for three acclimatising nights, then Machu Picchu, then finally two nights in Cusco as your altitude-adapted last stop.
Each day is written to balance structure with breathing room. Named hotels, named meals, named activities; logistics noted where they matter.
Land at LIM, 45-minute transfer to Miraflores (the cliff-top Pacific neighbourhood). Dinner at La Mar (Gastón Acurio's cevicheria) or a lower-key sit-down at Isolina. Walk the Malecón at dusk.
Morning at Larco Museum (pre-Columbian ceramics, exceptional). Lunch at Central (Virgilio Martínez's altitudinal tasting menu — #1 in the World's 50 Best 2023, book 3+ months ahead; or Maido is the alternative). Afternoon walking Barranco (bohemian, colourful, the counterweight to polished Miraflores). Dinner at Isolina.
Morning tour of Lima's colonial centre — Plaza Mayor, San Francisco monastery (the catacombs beneath hold 25,000 skeletons), Santo Domingo church. Lunch at Amaz (Amazon-ingredient focused) or La Picantería. Afternoon at MALI (Lima Art Museum). Last Lima dinner at Astrid y Gastón.
Early flight Lima → Cusco (1h 20m). Do not stay in Cusco yet — at 3,400m altitude sickness is common. Transfer directly to the Sacred Valley (2,800m, much easier on the body). 90-minute drive down. Check in at a Sacred Valley hotel; afternoon rest, hydrate, chew coca leaves.
Morning at Pisac ruins + the Pisac Sunday market (if Sunday; Tuesdays/Thursdays are smaller). Lunch at Hacienda Huayoccari. Afternoon at Moray (the Inca agricultural terraces laid out in concentric circles) and the Maras salt pans (still producing salt since pre-Inca times).
Morning at Ollantaytambo — the living Inca town where the streets still follow the original Inca plan. Climb the temple hill above the town (500 steps, moderate). Lunch in the town square. Afternoon at a chicha (corn beer) tasting at a local chichería.
Early morning train Ollantaytambo → Aguas Calientes (90 min via PeruRail or Inca Rail). Bus up to Machu Picchu (25-min switchback road). Morning at Machu Picchu with a licensed guide; afternoon return. Stay overnight at Aguas Calientes to split the visit across two days, OR do it all in a single long day with return to Sacred Valley.
Second Machu Picchu entry — climb Huayna Picchu (the peak in every Machu Picchu photo, booking required, 2.5 hours round-trip) or the gentler Machu Picchu Mountain. Afternoon train back to Ollantaytambo, then transfer up to Cusco (90 min drive). Check into a Cusco hotel.
Morning Cusco walking tour: Plaza de Armas, the Cathedral (the 'Last Supper with Guinea Pig' painting), Qoricancha (the Inca Sun Temple incorporated into the Santo Domingo church). Lunch at Cicciolina. Afternoon in the San Blas artisans' quarter (silver, ceramics, textiles). Dinner at Chicha (Acurio's Cusco restaurant).
Morning at Sacsayhuamán (the Inca fortress above Cusco, with the zig-zag stone walls). Flight back to Lima + onward international. Allow 3 hours at CUZ airport — flights often delayed for afternoon weather.
Yes — Cusco at 3,400m affects a significant minority of visitors. The acclimatisation pattern (Sacred Valley 2,800m first, Cusco last) works much better than flying straight to Cusco. Coca tea, hydration, and 48 hours of rest are the standard remedies. Consult your doctor about altitude-sickness prophylaxis (acetazolamide).
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