Alejandro Velasco Astete International Airport — Cusco, Peru

Perched at roughly 3,300 meters in the Peruvian Andes, Cusco's airport, named for an early Peruvian aviator and coded CUZ, ranks among the highest-elevation airports handling significant international traffic anywhere in the Americas. Surrounding mountains constrain the single runway's length and approach paths, restricting some wider-body aircraft and requiring careful performance planning given the thin air at altitude. Nearly every visitor bound for Machu Picchu, the Sacred Valley, or the former Inca capital's cobblestone streets passes through this single terminal, making it one of Peru's busiest airports despite the geographic city's modest size. Altitude sickness affects many arriving travelers, prompting widespread use of coca tea and gradual acclimatization advice around the terminal. Plans to shift traffic to a new airport at Chinchero, on flatter ground nearby, have been discussed and delayed for years.