Before You Travel — Essentials
Visa
US citizens need a tourist visa. Get it on arrival at Kathmandu airport ($30/15 days, $50/30 days, $125/90 days) or apply online at immigration.gov.np. Bring exact USD cash for on-arrival visa.
Travel Insurance
Non-negotiable for Nepal. Must cover high-altitude helicopter evacuation (up to 6,000 m). Rescue from altitude without insurance can cost $5,000–$20,000 USD. World Nomads and IMG Global are popular choices.
Vaccinations
Consult your doctor 6–8 weeks before travel. Recommended: Hepatitis A & B, Typhoid, Tetanus. Consider: Japanese Encephalitis (for rural/long stays), Rabies. Malaria prophylaxis if visiting Chitwan or Terai.
STEP Registration
Register with the US Embassy's Smart Traveler Enrollment Program (STEP) at step.state.gov. You'll receive security updates and the Embassy can contact you in an emergency.
Money & ATMs
The Nepali Rupee (NPR) is the local currency. 1 USD ≈ 130 NPR (2025). ATMs are widely available in Kathmandu and Pokhara. Bring $100–$200 USD cash as backup. Notify your bank before travelling.
Power & Adapters
Nepal uses 230V/50Hz with Type C, D, and M plugs (round-pin). US travelers need a universal adapter. Power cuts (load shedding) can occur — a power bank is essential for trekking.
Altitude Sickness — Critical Reading
Acute Mountain Sickness (AMS) affects up to 50% of trekkers above 3,000 m regardless of age or fitness. It can be fatal if ignored. Learn the symptoms and protocol before you trek.
AMS Symptoms
Headache (most common), nausea/vomiting, dizziness, fatigue, loss of appetite, and difficulty sleeping. If symptoms progress to confusion, loss of coordination, or wet cough — descend immediately. This is High Altitude Cerebral/Pulmonary Edema — a medical emergency.
Prevention & Treatment
Ascend slowly — max 500 m/day above 3,000 m. Include acclimatization rest days. Stay well hydrated (3–4L water/day). Avoid alcohol above 3,500 m. Consult your doctor about Diamox (acetazolamide). Golden rule: if in doubt, descend.
Cultural Etiquette
Dos & Don'ts in Nepal
- Greet with "Namaste" (hands pressed together, slight bow) — deeply appreciated
- Remove shoes before entering temples, monasteries, and many homes
- Walk clockwise around stupas, prayer wheels, and mani stones
- Dress modestly at religious sites — cover shoulders and knees
- Ask permission before photographing people, especially during rituals
- Never point the soles of your feet at a person or sacred object
- Use your right hand (or both hands) to give and receive items
- Non-Hindus cannot enter the inner sanctum of many Hindu temples
Food & Water Safety
Nepal's food is generally safe at reputable restaurants. However, traveler's diarrhea is common among those who aren't careful with water and raw foods.
Water & Food Rules
- Never drink tap water — use sealed bottled water or purify/filter your own
- On trekking trails, use iodine tablets or a SteriPen UV purifier (more eco-friendly)
- Avoid raw salads, unpeeled fruit, and uncooked vegetables in local restaurants
- Dal bhat and cooked street food from busy vendors is generally safe
- Carry oral rehydration salts (ORS) in case of stomach illness
Getting Around Nepal
Domestic Flights
Essential for reaching Lukla (EBC), Pokhara, Chitwan, and remote regions. Small Twin Otters and ATR72s operated by Yeti Airlines, Buddha Air, and others. Book in advance; weather delays are common.
Tourist Buses
Air-conditioned tourist coaches connect Kathmandu–Pokhara (7 hrs, $10–$15) and Kathmandu–Chitwan (5 hrs, $8–$12). Comfortable and reliable for the main routes. Book through your hotel or Thamel agencies.
Taxis & Ride-share
Metered taxis are widely available in Kathmandu. Apps like Pathao and InDrive offer transparent pricing. Always confirm the fare before getting in an unmarked cab, or insist on the meter.
Safety in Nepal
Nepal is one of the safer countries in Asia for tourists. Violent crime against foreigners is rare. The main safety considerations are altitude health, road accidents, and petty theft.
Register with the US Embassy STEP program before departure. Keep photocopies of your passport and visa separate from the originals. Use ATMs inside bank branches. On treks, always tell your teahouse host your next day's planned destination. Purchase comprehensive travel insurance before you leave the US.