OBJECTIVES To review the patient characteristics and management of 56 cases of high altitude pulmonary edema (HAPE) at the Pheriche Himalayan Rescue Association Medical Aid Post, and to measure the use of medications in addition to descent and oxygen. METHODS In a retrospective case series, we reviewed all patients diagnosed clinically with HAPE during the 2010 Spring and Fall seasons. Nationality, altitude at onset of symptoms, physical examination findings, therapies administered, and evacuation methods were evaluated. RESULTS 23% of all patients were Nepalese, with no difference in clinical features compared to non-Nepalese patients. 28% of all patients were also suspected to have high altitude cerebral edema. 91% of all patients developed symptoms at an altitude higher than the aid-post (median altitude of onset of 4834m). 83% received oxygen therapy; 87% received nifedipine, 44% sildenafil, 32% dexamethasone, and 39% acetazolamide. Patients administered sildenafil, dexamethasone, or acetazolamide had presented with significantly lower initial oxygen saturations (p ≤.05). After treatment, 93% of all patients descended; 38% descended on foot without a supply of oxygen. CONCLUSIONS A significant number of patients presenting to the Pheriche medical aid post with HAPE were given dexamethasone, sildenafil, or acetazolamide in addition to oxygen, nifedipine and descent. This may be related to perceived severity of illness and evacuation limitations. While no adverse effects were observed, the use of multiple medications is not supported by current evidence and should not be widely adopted without further study.