Above roughly 4,000 metres the air holds about 40 percent less oxygen than at sea level, water boils at 86 °C, and every physical task costs more effort. People live there anyway — hundreds of thousands of them, in cities built around mines, monasteries and high plateaus. These are the highest cities and permanent settlements in the world, each elevation measured at the settlement centre.
What is my elevation? Check live →The world's highest settlements, ranked
| # | Settlement | Country / Region | Elevation (ft) | Elevation (m) | Note |
|---|---|---|---|---|---|
| 1 | La Rinconada | Peru | 16,532 ft | 5,039 m | highest permanent settlement on Earth |
| 2 | Cerro de Pasco | Peru | 14,121 ft | 4,304 m | |
| 3 | El Alto | Bolivia | 13,425 ft | 4,092 m | |
| 4 | Potosi | Bolivia | 12,999 ft | 3,962 m | |
| 5 | Oruro | Bolivia | 12,877 ft | 3,925 m | |
| 6 | Shigatse | China (Tibet) | 12,618 ft | 3,846 m | |
| 7 | Juliaca | Peru | 12,559 ft | 3,828 m | |
| 8 | Puno | Peru | 12,530 ft | 3,819 m | |
| 9 | Lhasa | China (Tibet) | 12,005 ft | 3,659 m | |
| 10 | Leh | India | 11,201 ft | 3,414 m | |
| 11 | Cusco | Peru | 10,951 ft | 3,338 m | |
| 12 | Huancayo | Peru | 10,705 ft | 3,263 m | |
| 13 | Golmud | China | 9,245 ft | 2,818 m | |
| 14 | Toluca | Mexico | 8,757 ft | 2,669 m | |
| 15 | Bogota | Colombia | 8,389 ft | 2,557 m | |
| 16 | Quetzaltenango | Guatemala | 7,680 ft | 2,341 m | |
| 17 | Arequipa | Peru | 7,618 ft | 2,322 m | |
| 18 | Xining | China | 7,428 ft | 2,264 m | |
| 19 | Shimla | India | 7,201 ft | 2,195 m | |
| 20 | Kunming | China | 6,217 ft | 1,895 m |
Rankings of this kind disagree because “city” has no universal definition. La Rinconada is a town of tens of thousands with no municipal status; El Alto is a formally incorporated city of more than a million. Both entries are listed here with their measured elevation so you can apply whichever definition you prefer.
La Rinconada: the highest place people permanently live
At roughly 5039 m (16,532 ft) in the Peruvian Andes, La Rinconada is the highest permanent human settlement on Earth. It exists because of gold: the town sits beneath the La Bella Durmiente glacier, and the mine beneath it draws workers who accept extraordinary conditions. There is no sewage system and no piped water. Oxygen at this altitude is roughly half that of sea level, and researchers studying the population have documented chronic mountain sickness at rates found almost nowhere else.
El Alto: the highest large city
El Alto in Bolivia, at about 4092 m, is a different case entirely — a genuine metropolis of over a million people on the plateau above La Paz. It grew from a suburb into Bolivia's second-largest city within a generation. Its airport, at a similar elevation, requires runways far longer than usual because thin air reduces both wing lift and engine thrust.
Why the Andes and the Tibetan Plateau
Nearly every settlement in this list sits in one of two regions, and the reason is geological. Both the Andes and the Tibetan Plateau combine great height with something rarer: large areas of relatively flat, habitable ground at that height. The Altiplano and the Tibetan Plateau are high but not steep, which makes agriculture, roads and cities physically possible. The Himalaya by contrast is higher still and almost entirely unlivable, because there is nowhere level to build.
Populations in both regions also carry genetic adaptations to altitude developed over thousands of years — Tibetans breathe faster and maintain higher blood oxygen saturation, Andean peoples carry more haemoglobin. Visitors have neither advantage.
Frequently asked questions
What is the highest city in the world?
La Rinconada in Peru, at roughly 5039 m (16,532 ft), is the highest permanent settlement on Earth. If you require formal city status, El Alto in Bolivia at about 4092 m is the highest large city, with over a million inhabitants.
Is it dangerous to live at 5,000 metres?
Long-term residence above about 4,500 m carries real health risks. Chronic mountain sickness, in which the body overproduces red blood cells and thickens the blood, is common in La Rinconada. Most medical guidance considers permanent habitation above 5,000 m to be at the edge of what humans tolerate.
Why is Lhasa often called the highest city?
Lhasa at about 3659 m was long described that way in Western sources because it was the highest city widely known outside its region. Several Andean cities are considerably higher.
How does altitude affect cooking and aircraft?
Water boils at roughly 86 degrees Celsius at 4,000 m, so food needs longer cooking or a pressure cooker. Aircraft need markedly longer runways because thin air reduces both lift and engine thrust — which is why high-altitude airports have some of the longest runways in the world.