As Manaslu Tsum Valley trek is designed for mountains lover who would like to visit the foot of the world's eighth highest mountain Mount Manaslu (8,163m), and its surrounding pristine nature. This is high altitude trip crossing through the Larkya La Pass 5160 meters. I am sure you are physically fit for the Manaslu trip, and for the high altitude sickness also you do not have to worry about this trip, due to begin from a Low elevation at Arughat (535m) and goes gradually to the Tsum Valley side at Mu Gumba (3700) highest elevation. Then drop to Pewa below (1766m) and again gradually head up to Larkya Pass at an elevation of 5160m. And you have acclimatization day in Sama Gaun also. So, your body will be already well acclimatizing before getting into the pass, as result, you can cross pass without any problem. Compare to the other passes like Everest and Annapurna, the Larkya Pass is much easier. The trail from Dharmashal goes gently until to the top, you are not feeling going to pass. But other passes like Thorangla (5416m) at Annapurna, Chola Pass (5420), and Kongma La in Everest Region are more difficult. However, you need to be physically fitness and mentally well prepared to walk 4 to 5 hours most of the day and someday 8 to 9 hours in the high elevation. According to our guest history, we have successfully organized this trip without any disturbance. I wish you will also put another record in our client’s history.  You need to do some physical exercise a few months prior then your trip.  You may, hiking every weekend for 1 to 2 hours or do cardiologist exercise or do yoga and meditation every day or do Zumba dance exercise or participate in the health club, etc. This trek can do by first-time trekkers also if you are an Intermediate hiker, this is best for you. Keep your strength continue.