Sacred Valley — how much can you realistically fit in?

Everyone's priorities are different, I think, but here's what we did:

We hired a driver to take us from Cusco to the Pisca Ruins and nearby market and then to Urubamba. (We has a particular reason for visiting Urubamba, though). Then, he took us on to Ollantaytambo where we visited the ruins and spent the night before heading to Aguas Calientes by train. We stayed overnight in Aguas Calientes to visit the Machu Picchu citadel twice. Then we took the train to Cusco where we spent a couple of nights and visited the Sacsayhuaman Ruins, the Inca walls, and other sights in the town, before flying back to Lima and spending a couple of days there.

We thought that worked brilliantly.

Here is the company we used: http://www.cuscotransport.com/

We did a wonderful four day. tour of Cuzco, the Sacred Valley and Machu Picchu in 2019 with PeruAgency.com

We stayed in great hotels, the one in Cuzco was over 250 years old, very historic and nice. The one near MP was a newer 3 star, but nice.
Our guide had a University education in history and was great. We visited great places in Cuzco, then several place in the Sacred Valley en route to where we picked up the train to Aqua Calientes. The city were we picked up the train was very historic and we did spend a bit of time there.

Cost of the tour was about $750 pp but didn't include air from Lima to Cuzco.

We had limited time when we went, too. What we did was fly into Cuzco, get a taxi to Ollantaytambo and spend the day/evening there, the next day in the afternoon get the train to Aguas Calientes and spend the night, see Machu Picchu the next day, and then afterwards take the train plus taxi back all the way to Cuzco for two more nights. It’s advisable not to start with Cuzco because of the altitude- so if you’re flying into Cuzco, immediately descend to somewhere like Ollantaytambo which will help you to acclimate. Good luck with your planning!

I went to Peru in July 2025. Here is a summary of part of my itinerary. Use this as a rough approximate guideline about how much you might be able to fit in. You may want to give yourself 5 or 6 days total for Cusco and the ruins in and near the sacred valley area depending on what you want to see and what you are willing to skip.
Thursday: Bus arrives in Cusco 7:40am. Taxi reservation to hotel in Ollantaytambo. The commonly visited ruins and the less commonly visited ruins on a hill where it is free but potentially dangerous. Don't hike up the steps too fast. Sleep in Ollantaytambo
Friday: Machu Picchu timed ticket for 1:00pm. Train leaves 8:29am. Must arrive at the train stations 1/2 hour or more before. Bus the rest of the way to Machu Picchu site. Bus back to Aguas Calientes.
2nd night in Ollantaytambo
Saturday: Chinchero, Maras, Moray tour with Taxidatum, arrives at hotel in Ollantaytambo at 9:00am. Ending at the hotel in Cusco. Sleep in Cusco
Sunday: Taxidatum tour of Pisac ruins, Pisac market and 4 Cusco area ruins. 2nd night in Cusco
Monday: Various museums and sites. 3rd night in Cusco
Tuesday: Taxi to the airport in Cusco at 10:45am

Taxidatum is the company I reserved my tours with. The trips were just me and the driver. The driver needed cash and the exact amount. I gave them some grief making them wait while I ran around trying to get change. Get exact change before your tour. Also I wish I had gotten the driver's phone number because I had 3 times when I had forgotten the exact spot i was dropped off or couldn't find my driver.

The highest site I was at was just over 12 thousand feet. Before my trip I got persuaded that I would be likely to experience some altitude sickness. The elevation did not cause me a problem. In some places, the roads in the area have a lot of curves and/or the speed limits are low.

Edit: At the main ruins in Ollaytaytambo, and at an office in Cusco, you can buy a combined ticket that includes 14 sites. I made the mistake of wasting about $25 U.S. dollars because I paid for only the site at Ollantaytambo instead of the combination ticket, and then later in Cusco I ended up buying the combination ticket that includes the site at Ollantaytambo, so I could go to a few sites in Cusco.

I live in Lima; you have some good itinerary suggestions above. Two days is too quick for the Sacred Valley; four is probably the minimum. We spent a week there and didn't see everything we wanted. The altitude made all of us tired which slowed things down a bit. As others said, leave Cusco right away to adjust easier to the change in elevation.