Safety in Bhutan

The general picture. One of the calmest countries in Asia, with no hostility towards visitors at all. The real dangers are altitude sickness and the mountain roads, not people.
Altitude. Thimphu sits at two thousand metres and the monasteries are higher again. Do not charge uphill on day one; give your body time and drink plenty of water.
Dogs. Streets have many strays, which Buddhists feed but do not neuter. They doze through the day and gather into loud packs at night, which can wreck your sleep.
Leeches. In the forests and on the trekking trails they are active during the rainy season. Wear high socks and closed shoes, and check your clothing after any walk through grass.
Tobacco. Selling tobacco is illegal and carries a prison sentence. Smoking is confined to designated areas, and any cigarettes you bring must be declared and taxed at customs.
Medical care. State clinics treat visitors free in emergencies, but the equipment is basic. Serious injuries mean a complicated evacuation to India, so insure accordingly.
Advisories. Check your own government's travel advice before booking, and make sure your policy covers high-altitude trekking if the Tiger's Nest or longer routes are on the plan.

Bhutan is arranged so that fraud is nearly impossible: independent tourism is restricted and virtually all visitors travel on a pre-paid programme with a licensed guide.

How entry works. A Sustainable Development Fee applies — a fixed sum per night paid to the state separately from the tour price. The amount has changed over time and should be checked immediately before travelling. Citizens of India, Bangladesh and the Maldives enter on different terms.

Guides and agencies. You may only travel through a licensed Bhutanese operator. The register is published officially and checking an agency is straightforward. Schemes offering a "cheap tour around the rules" are either fraud or a breach you will answer for.

Souvenirs. Thangkas, textiles and woodwork. Prices are fixed in shops and haggling is fine at markets. Deception is rare.

Cash. International cards work poorly and ATMs are few. Bring cash; Indian rupees are accepted alongside the ngultrum.

Tobacco. Bhutan was for years the only country with a total ban on tobacco sales. Sales are now permitted at high duty, but imports are limited, smoking in public is prohibited, and undeclared tobacco is confiscated. Vapes are banned.

Religious sites. Access to dzongs and temples is not universal, and photography inside sanctuaries is prohibited almost everywhere. Dress is covered, hats come off, and stupas and altars are circled clockwise only. Your guide will see to it, and it is no formality: the country is seriously religious.

Images of the Buddha. As in other Buddhist countries, disrespectful treatment is unacceptable. Visible tattoos are best covered.

Exporting antiquities. Religious objects, antiques and items above a certain age may not be taken out.

Drones. Permission is required and is effectively unobtainable for a tourist.

Mountaineering. Climbing peaks above 6,000 metres is prohibited — the mountains are regarded as the abode of deities. One of the few such bans in the world.

Drugs. The law is strict.

Altitude is the main medical factor. Paro sits at 2,200 metres, Thimphu at 2,300, the road passes above 3,000, and Taktsang (the Tiger's Nest) is a climb to 3,100. Altitude sickness occurs among visitors, especially in the first days. Flying into Paro straight from the lowlands means that gain in a couple of hours. No exertion on day one; trekking from day three.

Trekking. Routes such as Jomolhari and the Snowman go above 4,500 to 5,000 metres and demand serious acclimatisation. Rescue infrastructure is minimal, helicopter evacuation is possible but weather-dependent and expensive. Your insurance must cover your route's altitude.

Vaccinations. None mandatory. Hepatitis A, typhoid and rabies are advised, plus malaria prophylaxis for the southern lowlands.

Water. Bottled or boiled only.

Healthcare. Public healthcare in Bhutan is free to everyone, foreigners included, but at a basic standard. The national hospital in Thimphu is the only substantial facility. Complex cases mean evacuation to India (Bagdogra, Delhi) or Bangkok.

Flying into Paro. The airport is considered one of the world's most difficult, with a visual approach between mountains, and flights are cancelled for weather. Allow spare time.

Bhutan is a very safe country with extremely low crime. Theft is rare and violent crime against foreigners is essentially unknown.

Police. Correct, and English is the language of instruction in the country, so there is almost no language barrier.

The guide as a safety system. The compulsory licensed guide, which many see as a restriction, also functions as insurance in practice: the guide is responsible for the route, knows conditions, and handles practical matters.

Reporting theft. Reports are taken; cases are rare.

Roads are the main physical risk. Bhutan's mountain hairpins are narrow, unguarded and beside drops, and landslides in the rainy season close roads for hours or days. The Paro–Thimphu–Punakha journey takes longer than the map suggests.

What actually matters. Nothing threatens you from people in Bhutan. All the risks are altitude, roads and weather, and all of them are built into the trip plan in advance.