North Macedonia Safety Guide
Health, security, and travel safety information
Emergency Numbers
Save these numbers before your trip.
Healthcare
What to know about medical care in North Macedonia.
Healthcare System
North Macedonia has a public healthcare system that provides basic medical care, supplemented by private clinics and hospitals. The public system is accessible but may have limited resources and longer waiting times. Private healthcare facilities, particularly in Skopje, offer higher standards and are more commonly used by international visitors.
Hospitals
Private hospitals and clinics in Skopje such as Remedika Hospital, Zan Mitrev Clinic, and Re-Medika provide good quality care and cater to international patients. In Ohrid, private clinics are available for tourists. For serious emergencies, medical evacuation to Greece (Thessaloniki is approximately 2 hours away) may be necessary.
Pharmacies
Pharmacies (апотека/apoteka) are widely available in cities and towns, typically marked with a green cross. Many common medications are available over the counter, often at lower prices than Western Europe. Pharmacists are generally knowledgeable and some speak English. Prescription medications from abroad should be brought in original packaging with documentation. 24-hour pharmacies exist in major cities.
Insurance
Travel insurance with comprehensive medical coverage and emergency evacuation is strongly recommended and essential. North Macedonia does not have reciprocal healthcare agreements with most countries, so visitors will need to pay for medical treatment upfront and claim reimbursement from insurance.
Healthcare Tips
- Bring sufficient supplies of any prescription medications as specific brands may not be available
- Keep copies of prescriptions and medical documentation in English
- Private clinics require upfront payment; keep all receipts for insurance claims
- Dental care is of reasonable quality and significantly cheaper than Western Europe
- Water is generally safe to drink in cities but bottled water is recommended in rural areas
- Ensure your travel insurance includes medical evacuation coverage to Greece or Western Europe
Common Risks
Be aware of these potential issues.
Pickpocketing and bag snatching occur primarily in tourist areas, crowded markets, public transportation, and outdoor cafes. Thieves often work in pairs or groups to distract victims.
Road safety is a concern due to aggressive driving, poor road conditions, inadequate street lighting, and vehicles not always yielding to pedestrians. Rural roads can be particularly hazardous.
Unlicensed taxis and some licensed drivers may overcharge tourists, refuse to use meters, or take longer routes. This is particularly common at airports, bus stations, and tourist sites.
Packs of stray dogs are present in some areas, particularly in rural regions and on the outskirts of towns. While most are not aggressive, they can be territorial and may approach travelers.
While most areas have been cleared, some remote border regions may still have unmarked minefields from past conflicts, particularly near the Kosovo border.
Mountain hiking can be hazardous due to sudden weather changes, inadequate trail marking, and limited rescue services. Trails may not be well-maintained.
Scams to Avoid
Watch out for these common tourist scams.
Some restaurants in tourist areas may add items you didn't order to your bill or charge inflated prices for items not clearly listed on the menu. Cover charges or bread charges may be added without prior notice.
Unofficial money changers or exchange offices may offer attractive rates but use rigged calculators, give incorrect amounts, or swap bills during the transaction. Some may have hidden fees in small print.
Individuals posing as plain-clothes police officers may approach tourists asking to see identification and wallets to 'check for counterfeit currency' and then steal cash or card information.
Some nightclubs, particularly those with aggressive promoters, may charge exorbitant prices for drinks or add unexpected service charges. Intimidation tactics may be used to force payment.
Some budget accommodations may show attractive photos online but provide significantly inferior rooms, or claim the advertised room is unavailable and offer a worse alternative at the same price.
Safety Tips
Practical advice to stay safe.
General Safety
- Register with your embassy if staying for an extended period
- Keep copies of important documents separate from originals
- Share your itinerary with family or friends back home
- Learn basic Macedonian phrases including emergency terms
- Keep emergency numbers saved in your phone
- Be aware of your surroundings, especially in crowded areas
- Trust your instincts - if something feels wrong, remove yourself from the situation
Money and Valuables
- Use ATMs inside banks during business hours when possible
- Carry only necessary cash and cards; leave extras in hotel safe
- Use money belts or concealed pouches for important documents
- Notify your bank of travel plans to avoid card blocking
- Have emergency cash in a separate location from your main wallet
- Avoid displaying expensive jewelry, watches, or electronics
- Make digital copies of credit cards and store securely online
Transportation
- Avoid traveling on intercity buses at night if possible
- Book buses and taxis through reputable companies or your hotel
- Keep luggage within sight on public transportation
- Wear seatbelts in vehicles; they are mandatory
- Be extremely cautious as a pedestrian; drivers often don't yield
- If renting a car, inspect it thoroughly and photograph any damage
- Carry an international driving permit along with your license
Accommodation
- Use hotel safes for passports, extra cash, and valuables
- Check that doors and windows lock securely
- Know the emergency exits and evacuation procedures
- Don't open doors to unexpected visitors; verify identity through reception
- Keep your room number private; don't announce it publicly
- Use the door security chain or deadbolt when inside
- Report any suspicious activity to hotel management immediately
Food and Water
- Tap water is generally safe in cities but bottled water is recommended
- Choose busy restaurants with high turnover for fresher food
- Be cautious with street food; ensure it's freshly cooked and hot
- Wash hands frequently, especially before eating
- Avoid ice cubes unless you're confident about water quality
- Be cautious with raw vegetables and unpeeled fruits in budget establishments
- Bring basic medications for stomach upset as a precaution
Political Situation
- Avoid all political demonstrations and large gatherings
- Be respectful when discussing political topics, especially ethnic tensions
- Monitor local news for any developing situations
- Avoid the use of the name 'Macedonia' vs 'North Macedonia' in sensitive contexts
- Be aware that ethnic tensions, while generally calm, can be a sensitive topic
- Follow advice from local authorities during any civil unrest
- Keep away from government buildings during protests
Communication
- Purchase a local SIM card for reliable communication
- Download offline maps before traveling to remote areas
- Learn basic Cyrillic alphabet to read signs
- Save important addresses in both Latin and Cyrillic script
- Have your accommodation address written in Macedonian
- Use translation apps; English is not widely spoken outside tourist areas
- Keep your embassy's contact information readily accessible
Information for Specific Travelers
Safety considerations for different traveler groups.
Women Travelers
North Macedonia is generally safe for women travelers, including solo female travelers. Macedonian society is relatively conservative but welcoming to tourists. Women may experience occasional verbal harassment or catcalling, particularly in less touristy areas, but physical harassment is uncommon. The larger cities like Skopje and Ohrid are more accustomed to independent female travelers. Standard precautions should be sufficient for a safe visit.
- Dress modestly, especially in rural areas and religious sites; covering shoulders and knees is respectful
- Avoid walking alone late at night in poorly lit or deserted areas
- Use registered taxis or ride-hailing apps rather than accepting rides from strangers
- Be assertive but polite if experiencing unwanted attention; ignore catcalls
- Consider staying in accommodations with good reviews from other female travelers
- Keep your phone charged and share your location with trusted contacts
- Sit near other women or families on public transportation if possible
- Wedding rings or mentioning a husband/partner can deter unwanted attention
- Carry yourself confidently and avoid appearing lost or vulnerable
- Join group tours for activities in remote areas rather than going alone
- Be cautious when drinking alcohol; never leave drinks unattended
- Trust your instincts; remove yourself from uncomfortable situations immediately
LGBTQ+ Travelers
Homosexuality is legal in North Macedonia (decriminalized in 1996), and there are anti-discrimination laws in place. However, same-sex marriage and civil unions are not recognized. The age of consent is equal for all (age 14). Despite legal protections, enforcement can be inconsistent.
- Exercise discretion regarding sexual orientation and gender identity, especially outside Skopje
- Avoid public displays of affection with same-sex partners
- Research LGBTQ+-friendly accommodations in advance; some hotels may be unwelcoming
- Connect with local LGBTQ+ organizations like LGBT United Macedonian or Subversive Front for current advice
- Be cautious on dating apps; meet in public places and don't share accommodation details
- Skopje has a small LGBTQ+ scene with a few welcoming cafes and bars; ask locals for recommendations
- Rural areas and smaller towns are generally less accepting than Skopje
- Consider booking private accommodations through LGBTQ+-friendly platforms
- Be prepared for questions about marital status; deflection may be easier than coming out
- Transgender travelers may face additional challenges; carry documentation if taking hormones
- Have your embassy contact information readily available
- Consider travel insurance that doesn't exclude coverage based on sexual orientation
Travel Insurance
Travel insurance is essential for visiting North Macedonia. The country does not have reciprocal healthcare agreements with most nations, meaning visitors must pay upfront for all medical treatment. Medical evacuation to neighboring countries or back home can be extremely expensive. Additionally, insurance provides protection against trip cancellations, lost luggage, theft, and other travel disruptions that are more likely in destinations with developing infrastructure.
Planning your trip? Make sure you have the right travel insurance for North Macedonia Safety Guide before you go.