This correspondence focuses on international travellers participating in ayahuasca ceremonies, excluding any use of the substance (or deaths) by local people or people partaking in their home country. It focuses only on key aspects necessary to understand the need to advise travellers. The number of travellers using ayahuasca is estimated to be in the tens of thousands; the number of deaths reported in the media is small, the number of unreported deaths unknown, making any risk calculation impossible. The deaths occurred under different circumstances, and the link to ayahuasca itself is unclear. However, this is moot when travellers do not return home alive. With increasing demand and popularity, and growing numbers of self-proclaimed ‘shamans’, more media headlines may be on the horizon. Travel health professionals' counsel is, therefore, crucial.