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Altitude-related conditions can range from mild and discomforting to severe and life-threatening. Acute mountain sickness (AMS) is a common condition in those with a recent elevation change above 8000 feet. Although it is usually mild, it may be severe enough to warrant emergency medical services (EMS) activation, especially in a challenging environment. High-altitude pulmonary edema (HAPE) and high-altitude cerebral edema (HACE) are life-threatening diagnoses, and EMS will almost certainly be involved in these cases. EMS is uniquely positioned to assist in these cases as evacuation is not simply getting patients to treatment; evacuation, specifically, descent from the affecting elevation and hypoxic environment, is the treatment. Any EMS system that will potentially be operating at altitudes near or over 8000 feet above sea level should be prepared to deal with altitude-related conditions.