Ishita Rao
Head of Editorial · 2026-07-04
Leh sits at 3,500 metres. You arrive there by aircraft in eighty-five minutes from Delhi, which means your body goes from 216 metres to 3,500 metres with no adjustment whatsoever. Then most itineraries drive you to Pangong Tso at 4,350 metres on day two, over the Chang La pass at 5,360 metres.
This is why so many Ladakh holidays include a day spent unwell in a hotel room.
What acclimatisation actually requires
Two full days in Leh before going higher. Not one. Day one is complete rest — no sightseeing, no monastery steps, no walking to the market. Day two is gentle and local: Shanti Stupa, the old town, an early night.
From day three you can go higher, and the rule of thumb is not to sleep more than 500 metres higher than the previous night.
The practical checklist
- Book a morning flight; Leh's weather window closes by mid-morning
- Hydrate aggressively — three to four litres a day
- No alcohol for the first 48 hours, and go easy after that
- Discuss acetazolamide with your physician before you travel
- Choose a hotel with oxygen-equipped rooms; several in Leh have them
- Insist that your vehicle carries oxygen on high-pass days
Warning signs to take seriously
Headache, nausea and breathlessness at rest are your body telling you to descend. Confusion or an inability to walk a straight line are medical emergencies requiring immediate descent, not a wait-and-see.
Why we will refuse a short Ladakh trip
We will not sell a five-night Ladakh itinerary that includes Pangong. It is a bad trip and an avoidable medical risk, and no amount of enthusiasm changes the physiology. Seven nights, two acclimatisation days, oxygen in the vehicle. That is the version that works.
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