Peatlands store large amounts of carbon (C), a function potentially threatened by climate change. Peatlands composed of vascular cushion plants are widespread in the northern and central high Andes (páramo, wet and dry puna), but their C dynamics are hardly known. To understand the interplay of the main drivers of peatland C dynamics and to infer geographic patterns across the Andean regions, we addressed the following question: How do topography, hydrology, temperature, past climate variability, and vegetation influence the C dynamics of these peatlands? We summarize the available information on observed spatial and inferred temporal patterns of cushion peatland development in the tropical and subtropical Andes. Based on this, we recognize the following emerging patterns, which all need testing in further studies addressing spatial and temporal patterns of C accumulation: (1) Peatlands in dry climates and those in larger catchments receive higher sediment inputs than peatlands from wet puna and páramo and in small catchments. This results in peat stratigraphies intercalated with mineral layers and affects C accumulation by triggering vegetation changes. (2) High and constant water tables favor C accumulation. Seasonal water level fluctuations are higher in wet and dry puna, in comparison with páramo, leading to more frequent episodes of C loss in puna. (3) Higher temperatures favor C gain under high and constant water availability but also increase C loss under low and fluctuating water levels. (4) C accumulation has been variable through the Holocene, but several peatlands show a recent increase in C accumulation rates. (5) Vegetation affects C dynamics through species‐specific differences in productivity and decomposition rate. Because of predicted regional differences in global climate change manifestations (seasonality, permafrost behavior, temperature, precipitation regimes), cushion peatlands from the páramo are expected to mostly continue as C sinks for now, whereas those of the dry puna are more likely to turn to C sources as a consequence of increasing aridification.