Background: The present study aims to analyze the epidemiological data of COVID-19 in Indian subcontinent in terms of altitude, to understand the difference in body’s response to COVID at high altitudes in comparison to low-lands and to understand whether physiological adaptation to counteract hypoxic environment at high altitudes, is also protective against adverse impacts of COVID-19. Material and Methods: The relationship of the reported positive cases and COVID deaths per million population was compared at different altitudes. Results: COVID-19 positive cases decline with high altitude. Conclusion: There might be a positive role of high altitudes in decreasing the prevalence of COVID-19 infection. Various environmental and physiological factors that might contribute to the altitudinal variations in COVID-19 are also discussed.