The Inca Trail passes directly through the UNESCO World Heritage Site of Machu Pichu. After considering years of damage, the U.N. demanded that the Peruvian government legislate tours and trekkers more stringently. Since 2001, there are laws regarding the size of tour groups, the number of treks allowed daily and the equipment that can be taken. In addition, only officially licensed companies can take trekkers to the trail. This means you cannot hike the trail without an officially licensed guide, so make sure you work with an official company to plan your trip.
Short, two-day hikes may only reach 2,750 meters (9,020 feet) above sea level, but the typical four-day hike passes through the legendary "Dead Woman's Pass" and reaches 4,200 meters (13,800 feet). You will experience lightheadedness, shortness of breath and lack of oxygen if you do not prepare. These can be very serious problems on a vigorous hike. The best way to prepare is to stay in Cuzco for a few days before the trip and allow your body to adjust to the change in elevation and oxygen in a relaxed setting.
The typical four-day hike is not for everyone, and you need to be honest about your physical limitations and level of interest. If you are not a strong hiker, be realistic and look for tour companies offering less strenuous trips. To have the safest and most enjoyable time, choose a tour that fits your physical abilities, then pack as lightly as possible.