High altitude is a challenging environment due to the reduced atmospheric pressure and oxygen availability, increased ultraviolet radiation, and reduced temperature relative to sea level. Previous studies in individuals who travel to high altitude demonstrate differential expression of genes involved in inflammation and innate immune system activation. This study aims to extend these findings by defining changes in immune cell population distributions and cell phenotypes during travel to high altitude. We hypothesized that acute high-altitude exposure would lead to shifts in immune cell populations toward a pro-inflammatory phenotype due to cellular stress caused by hypoxemia and tissue hypoxia. Participants (N=17) traveled to Barcroft Station in the White Mountain Research Center (3800 m). Whole blood was collected during fasting at sea level on the morning of ascent and each morning at high altitude for three days. Cells in whole blood were fixed and stained within 1-2 hours of collection and were processed via flow cytometry upon return to sea level. We observed a decrease in classical monocytes on the first (p=0.010) and second (p=0.003) mornings of high-altitude acclimatization to sea-level baseline, and an increase in intermediate monocytes on the first (p=0.013) and second (p=0.014) mornings at high altitude. We also observed an increase in B cells on the second (p=0.004) and third (p=0.004) mornings at high altitude compared to sea-level baseline (mean: 3.53%, SD: ±1.82). These results indicate that acute high altitude exposure results in a shift toward a pro-inflammatory monocyte phenotype and supports prior research suggesting a significant role of hypoxia in modulating B cell function. This research was supported through funding provided by a private donor. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.