For some of us, journeying to high altitudes means we might contend with headaches, shortness of breath, nausea, and fatigue. For others, living among the clouds is just a way of life. 

The International Society of Mountain Medicine defines a “high-altitude” location as one that is over 4,900 feet above sea level. Areas above this altitude have lower levels of oxygen and are typically colder and less humid.

Yet our bodies can naturally adjust to these conditions. Just two weeks spent at high altitudes can impact blood cells for months, leaving them more resilient and capable of holding onto oxygen for much longer. 

People who spend their whole lives at high altitudes often acclimate to them through genetic and physiological adaptations that allow them to thrive in mountainous climates that would have the rest of us gasping for breath. Yet living far above the rest of humanity certainly can still pose a great deal of challenges.

1. La Rinconada, Peru
2. Tuiwa, Tibet, China
3. Rongbuk Monastery, Tibet, China
4. Lobuche, Nepal
5. Wenquan, Golmud, Qinghai, China

La Rinconada, Peru

The world’s highest inhabited permanent settlement is a not-so-little town in the Andes Mountains called La Rinconada. At a staggering three miles—or 16,700 feet—above sea level, this town is home to roughly 50,000 people. 

La Rinconada doesn’t have a sewage system or a garbage disposal, but what the land here does have is gold, and that’s what drew people to make a home so high in the mountains. The settlement emerged decades ago but soared in popularity in the early 2000s, when the price of gold soared. 

People here often suffer from chronic mountain sickness, or CMS, which can lead to dizziness, headaches, and even death. Many of the mines here are controlled by a company called Corporación Ananea, which uses an unregulated payment tactic called the cachorreo system. 

Under this, miners aren’t paid for their work but are allowed to carry off as much ore as they can after working for 30 days. They aren’t able to tell how much gold is in the ore until they get home, though, meaning many find themselves bitterly disappointed after their month in the mountains. 

Pollution here is rampant—people often live in makeshift shacks and burn trash to stay warm, and water sources are filled with mercury from the mines. There’s little law enforcement, so reports of theft, trafficking, and the like are common. Yet still people flock to this town, drawn towards the clouds by the siren song of precious metals.

Tuiwa, Tibet, China

At 16,500 feet, Tuiwa is often identified as the world’s second-highest village, yet it is remarkably different from La Rinconada. This ancient settlement is inhabited by people who have generally been living in harmony with the land for a very long time.

Most people here make their living through animal herding, driving flocks of sheep to a lush island in the center of the nearby Lake Puma Yumco every dry season and bringing them back afterwards. This practice of walking sheep across paths made of cow dung has been going on for thousands of years.

Yet life here can also be difficult and dangerous. The average life expectancy in the village is under 50, and many people still suffer from various symptoms of altitude sickness. Efforts to relocate villagers have been made in recent years, though some have refused to leave their ancestral homelands.

Because many people who live here are out with their sheep for long periods, the town can be extremely quiet at times. The village also has a temple on the shores of the brilliantly blue Puma Yumco, and many locals visit it regularly to burn incense and to spin prayer wheels.

Rongbuk Monastery, Tibet, China

There are several other Tibetan villages and settlements that are nearly as high up as Tuiwa’s. One particularly high-altitude place in Tibet is Rongbuk Monastery, which soars 16,340 feet above sea level, making it the highest monastery in the world. This small sacred site rests at the foothills of the Rongbuk Glacier, and is a few miles away from Everest Base Camp.

The area where Rongbuk was built was once a sacred site filled with caves where Buddhist monks had been meditating for centuries. Built in 1902 by Nyingmapa Lama Ngawang Tenzin Norbu, the monastery has long been a place where mountain climbers can stop to rest and make prayers. It is also a pilgrimage site for Sherpa people, who often come here to visit and pray.

Rongbuk was once home to around 500 monks and nuns, though today only a few dozen live there. Unusually, monks and nuns cohabit and meditate together here, a tradition that originated from the fact that monks and nuns used to share the meditation caves here before the monastery was built. Today, the monastery is also a popular stop for tourists visiting Tibet.

Lobuche, Nepal

This small settlement is located in Nepal’s Khumbu region, and is one of the last stops that trekkers typically make on their way to Everest Base Camp. Located 16,210 feet above sea level, this village is home to Sherpa people who have lived there for centuries.

The Sherpas here practice Buddhism and have a deep relationship with the mountains. Carnivals and religious celebrations frequently occur here, and often, Sherpa climbers will stop here to ask for blessings before moving on towards Everest’s peaks.

Travelers will find basic but comfortable lodging options here, as well as plenty of opportunities to fill up on the classic Nepali meal of dal bhat before trekking even further up.

Wenquan, Golmud, Qinghai, China

Wenquan is located at 15,980 feet above sea level. An outpost on the Qinghai-Tibet railroad that was founded in 1955, this is a small settlement that offers stunning views of mountains towering over dusty plains inhabited by snow leopards, antelopes, and wild yaks.

Not many people stop here to look around, but visitors claim it contains just a few buildings located against a vast, mountainous plateau—as well as some hot springs. 

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