In 1950, Maurice Herzog and Louis Lachenal became the first climbers to rea
ch the summit of an 8000m peak (Annapurna, 8091 m). In the half century sin
ce that pioneering climb, mountaineers have increasingly sought to climb th
e fourteen '8K peaks' of the Himalayas and Karakoram, with remarkable succe
ss; they have made 5085 ascents of those peaks up to the year 2000. While s
eeking adventure on those great peaks, mountaineers are inevitably exposed
to hypoxia, cold and dehydration as well as to the physical hazards of clim
bing. Those few mountaineers who successfully summit an 8K peak are likely
to be at or near their physiological limits and probably confront an elevat
ed probability of dying during their descent. We will briefly review some o
f the physiological challenges climbers face at extreme elevation and then
compare success rates and death rates on mountains of different heights (Ra
iner, Foraker, Denali, K2, Everest). Success rates decline with summit heig
ht, but overall death rates and death rates during descent from the summit
increase with summit height. Although these patterns are based on non-exper
imental and uncontrolled data, our findings are consistent with the hypothe
sis that increasing altitude is associated with decreased success and with
increased risk of death.