The altitude of northern areas destinations runs from about 1,500 metres in Gilgit and Chitral to 4,693 metres at Khunjerab Pass, the highest point most visitors reach by road. The towns people sleep in are nearly all below 2,600 metres. The lakes, meadows and passes they drive up to from those towns are 1,000 to 2,200 metres higher, and that jump, made in a few hours, is what causes trouble.
Below are the figures for the main towns, lakes and passes, then the height gained on each popular outing, and the standard medical rules for going up. For symptoms and treatment in detail, see our guide to altitude sickness in the northern areas.
Towns and valleys where you sleep
| Place | Altitude (m) | Region |
|---|---|---|
| Mingora | 984 | Swat |
| Abbottabad | 1,256 | Hazara |
| Chilas | 1,265 | Diamer |
| Chitral town | 1,494 | Chitral |
| Gilgit | 1,500 | Gilgit |
| Kalam | About 2,000 | Swat |
| Aliabad | 2,206 | Hunza |
| Skardu | 2,228 | Baltistan |
| Shigar | 2,230 | Baltistan |
| Murree | 2,291 | Punjab hills |
| Shogran | 2,362 | Kaghan |
| Naran | 2,409 | Kaghan |
| Nathia Gali | 2,410 | Galiyat |
| Gulmit | 2,465 | Upper Hunza |
| Karimabad | About 2,500 | Hunza |
| Astore | 2,546 | Astore |
| Arang Kel | About 2,550 | Neelum |
| Khaplu | About 2,600 | Baltistan |
| Sost | About 2,800 | Upper Hunza |
| Minimarg | 2,844 | Astore |
Lakes, meadows and viewpoints
| Place | Altitude (m) | Reached from |
|---|---|---|
| Upper and Lower Kachura lakes | About 2,500 | Skardu |
| Satpara Lake | 2,600 | Skardu |
| Borith Lake | 2,600 | Gulmit or Passu |
| Thandiani | About 2,750 | Abbottabad |
| Mushkpuri top | About 2,800 | Nathia Gali, on foot |
| Malam Jabba | 2,804 | Mingora |
| Lake Saiful Muluk | 3,224 | Naran |
| Fairy Meadows | About 3,300 | Raikot Bridge, jeep and walk |
| Rama | About 3,300 | Astore |
| Ratti Gali Lake | 3,683 | Dowarian, Neelum, jeep and walk |
| Dudipatsar Lake | About 3,800 | Besal, on foot |
| Ansoo Lake | 4,126 | Lake Saiful Muluk, on foot |
| Sheosar Lake, Deosai | About 4,250 | Skardu or Astore |
| Rush Lake | 4,694 | Hopar, two to three days on foot |
Passes and plateaus
| Place | Altitude (m) | Road |
|---|---|---|
| Lowari Pass | 3,118 | Dir to Chitral; traffic now uses the tunnel below it |
| Shandur Pass | About 3,700 | Chitral to Gilgit |
| Burzil Pass | 4,100 | Astore to Minimarg |
| Deosai plains | 4,114 on average | Skardu to Astore |
| Babusar Pass | 4,173 | Naran to Chilas |
| Concordia | 4,691 | No road; a week's trek up the Baltoro |
| Khunjerab Pass | 4,693 | Sost to the Chinese border |
The figures are the ones given in standard references. They vary a little between sources depending on where the reading is taken: Shandur is quoted at anything from 3,720 to 3,800 metres, Sheosar from about 4,140 to 4,250, and a town such as Skardu or Murree covers a couple of hundred metres from its lowest street to its highest.
How much height you gain on popular outings
The number that matters is not the altitude of the place but the gain since you last slept.
| Outing | Start | Top | Gain |
|---|---|---|---|
| Naran to Lake Saiful Muluk | 2,409 | 3,224 | About 800 m |
| Naran to Babusar Pass | 2,409 | 4,173 | About 1,750 m |
| Karimabad to Khunjerab Pass | 2,500 | 4,693 | About 2,200 m |
| Sost to Khunjerab Pass | 2,800 | 4,693 | About 1,900 m |
| Skardu to Deosai | 2,228 | 4,114 | About 1,900 m |
| Chilas to Fairy Meadows | 1,265 | 3,300 | About 2,000 m |
| Islamabad to Skardu by air | About 550 | 2,228 | About 1,700 m in an hour |
Someone who flies from Islamabad to Skardu in the morning and is driven up to Deosai that afternoon has gained more than 3,500 metres since breakfast. That is the pattern behind most altitude trouble on a northern trip.
What the medical guidance says
The standard reference for travel doctors, the US Centers for Disease Control's Yellow Book, sets out thresholds that map neatly onto this list.
- Risk begins at about 2,450 metres. Anyone who is not acclimatised and sleeps at that height or above can get acute mountain sickness. In Colorado, about a quarter of visitors who sleep above 2,450 metres do. That puts Karimabad, Khaplu and Sost just inside the zone, and Skardu and Naran just under it.
- Do not go from low altitude to sleeping above 2,750 metres in one day. Low means under about 1,200 metres. Coming up from the plains to a night at Fairy Meadows, with only a stop in Chilas at 1,265 metres, comes close to breaking this rule; Islamabad to Naran or Skardu does not.
- Above 3,000 metres, raise your sleeping height by no more than 500 metres a night, with an extra night for every 1,000 metres gained.
- Two or three nights at 2,450 to 2,750 metres first makes a marked difference before going higher.
- For the first 48 hours, avoid alcohol and anything more than gentle exercise.
The guidance is about where you sleep, which is why a day visit is so much more forgiving than a night. An hour at Khunjerab or a drive over Babusar is a brief exposure followed by a descent. A night on Deosai at 4,100 metres, straight from Skardu, is a jump of nearly 1,900 metres in sleeping height against a recommended 500.
Where to be careful
- Deosai overnight. The riskiest thing most road travellers do. Spend at least two nights in Skardu first, three if you flew in. If anyone has a headache that will not settle by evening, drive down.
- Fairy Meadows. It is a sleeping altitude of 3,300 metres, reached in one day from the Indus gorge. A night in Chilas or Gilgit on the way up is not enough to acclimatise, so go gently on the walk up, and we advise two nights there, not one, before any hike towards Nanga Parbat base camp.
- Khunjerab Pass. Nearly everyone feels breathless and some feel light-headed. Stay about an hour, walk slowly, and sleep at Karimabad or Sost afterwards.
- Babusar Pass. Crossed, not visited. Do not stop for long on top if you came up from Islamabad the day before.
- The towns. Gilgit, Chitral, Chilas, Skardu, Naran and Murree are low enough that most people notice nothing.
Who should take extra care
Anyone with a heart or lung condition, anyone pregnant, and anyone who has had altitude sickness before should see a doctor before a trip that includes Deosai, Khunjerab or Fairy Meadows. Our guide on high altitude for heart patients goes into this. Children generally cope as well as adults, but a young child cannot tell you about a headache, so watch for unusual crankiness, poor appetite and vomiting.
The symptoms to know are headache with nausea, dizziness, tiredness or loss of appetite, starting 2 to 12 hours after arriving. The rules are simple: admit it when you have them, never go up to sleep higher while you do, and go down if they get worse despite rest. Confusion, loss of balance or breathlessness at rest mean descend at once.
When we plan a Skardu trip, we put Deosai after at least two nights in town for this reason. The Skardu guide and our page on Hunza's altitude have more for those two areas.
Frequently asked questions
What is the highest place tourists reach by road in Pakistan?
Khunjerab Pass, at 4,693 metres, on the Karakoram Highway at the Chinese border. It is usually a day trip from Hunza.
Is Skardu high enough to cause altitude sickness?
Rarely. At 2,228 metres it is below the level where problems usually start. The risk comes from going up to Deosai, above 4,000 metres, too soon after arriving.
Which is higher, Khunjerab Pass or Babusar Pass?
Khunjerab, at 4,693 metres, is 520 metres higher than Babusar at 4,173 metres.
What is the altitude of Naran and Lake Saiful Muluk?
Naran is at 2,409 metres and the lake at 3,224 metres, a gain of about 800 metres over the jeep ride.
What is the altitude of Hunza?
The valley floor is about 2,440 metres. Aliabad is at 2,206 metres and Karimabad, on the slope above, at about 2,500 metres.
Do I need to acclimatise before Deosai or Khunjerab?
For a short day visit, a night or two in Skardu or Hunza first is usually enough. To sleep on Deosai, spend at least two nights in Skardu beforehand and be ready to drive down if anyone is unwell.
