The film opens with a group of photographs of the Stella Maris College's Old Christians Rugby Team. Carlitos Páez points out several members of the team and reflects on the accident in a brief monologue.
Uruguayan Air Force Flight 571 flies over the Andes on October 13, 1972. The raucous rugby players and a few of their relatives and friends are eagerly looking forward to an upcoming match in Chile.
Upon emerging from clouds, the plane encounters turbulence and collides with a mountain. The wings and tail are separated from the fuselage, which slides down a mountain slope before coming to a stop. Six passengers and one flight attendant are ejected from the plane and die. Antonio, the team captain, coordinates efforts to help the injured. Roberto Canessa and Gustavo Zerbino, both medical students, aid the injured. Another six passengers soon die, including both pilots and Nando's mother, Eugenia. Nando, who sustained a head injury, falls into a coma, and his sister Susana has suffered harsh internal injuries.
As the sun sets, the survivors make preparations for the night. Canessa discovers that the seat covers can be unzipped and used as blankets. The survivors go inside the fuselage and curl up beside one another to stay warm. Antonio, Roy Harley, and Rafael Cano plug the gaping hole at the end of the fuselage with luggage to keep out the wind. Two passengers die overnight. With nothing to hunt or gather on the mountain, Antonio declares they will use rationing when the survivors find a tin of chocolates and a case of wine. After seeing a plane fly past, they think it dips its wing, and the survivors celebrate. Expecting to be rescued the next day, everyone except Javier, his wife Liliana, and Antonio eat the remaining chocolates. This causes a quarrel among Antonio and several others.
Nando regains consciousness. After learning of his mother's death, Nando watches over Susana vigilantly. Knowing she will die of her injuries within a few days, he vows to set off on foot and find a way out of the mountains. When Carlitos reminds him that he will need food, Nando suggests eating the flesh of the deceased pilots to give him the strength to survive the journey to find help. Susana dies from her injuries. The survivors listen to a radio for word of their rescue but are devastated to hear the search called off after nine days.
After great debate, the starving passengers decide to eat the flesh of their dead relatives and friends. Zerbino, Rafael, and Juan Martino set off to search for the tail of the plane in hopes of finding batteries for the plane's radio to transmit their location. Among pieces of the wreckage, the teammates find additional corpses, but return to the group with news that the tail of the plane is likely a little farther away. Later in the week, an avalanche strikes the plane and fills much of the interior with snow. Eight of the survivors, including Antonio and Liliana, are smothered to death by the snow or breeze. The remaining 19 survivors are forced to stay inside the plane when they realize there is a blizzard outside.
A second team, made up of Nando, Canessa, and Antonio "Tintin" Vizintin, sets out and find the tail of the plane. Unable to bring the batteries to the fuselage, they return to the fuselage to get Roy, who is thought to have experience with electrical equipment. They bring him to the tail of the plane to see if he could fix the radio. When Roy is unsuccessful, the team decides to return to the fuselage.
Federico and Alberto die from their injuries, as does Rafael, leading Nando to convince a reluctant Canessa to search for a way out of the mountains, taking Tintin with them. Two days into the journey, they send Tintin back to the fuselage so they can appropriate his rations and continue on their own. After a 12-day trek, the two escape the mountains and alert the authorities to their companions' location. Two helicopters, one of which have Nando and Canessa onboard, appear overhead of the survivors on the mountain, leading the remaining 14 survivors to celebrate their impending rescue.
In the present, Carlitos describes how the survivors later returned to the site of the crash and buried the corpses under a pile of stones, marked with a cross. The memorial to the 29 deceased and 16 survivors is shown.
SURVIVORS
Ethan Hawke as Nando Parrado
Josh Hamilton as Roberto Canessa
John Haymes Newton as Antonio "Tintin" Vizintin
Bruce Ramsay (elder one: John Malkovich) as Carlitos Páez
David Kriegel as Gustavo Zerbino
Jack Noseworthy as Bobby Francois
Kevin Breznahan as Roy Harley
David Cubitt as Adolfo "Fito" Strauch
Gian DiDonna as Eduardo Strauch
John Cassini as Daniel Fernández
Richard Ian Cox as Ramón "Moncho" Sabella
Nuno Antunes as Álvaro Mangino
Gordon Currie as José Luis "Coche" Inciarte
Sam Behrens as Javier Methol
Michael Tayles as Alfredo Delgado
Steven Shayler as José Pedro Algorta
DECEASED
Michael Sicoly as the Pilot (Col. Julio César Ferradas)
Jerry Wasserman as the Co-Pilot (Lt. Colonel Dante Lagurara)
Tony Morelli as the Navigator (Lt. Ramón Martínez)
José Zúñiga as the Mechanic (Sgt. Carlos "Fraga" Roque)
Frank Pellegrino as the Steward (Sgt. Ovidio Joaquín Ramírez)
Illeana Douglas as Liliana Methol
Ele Keats as Susana Parrado
Jan D'Arcy as Eugenia Parrado
Vincent Spano as Antonio Balbi
Michael DeLorenzo as Rafael Cano
Danny Nucci as Hugo Díaz (survives in the film, even though his real life counterpart, Diego Storm, died in the avalanche)
Josh Lucas as Felipe Restano
Chad Willett as Pablo Montero
Michael Woolson as Juan Martino
Diana Barrington as Mrs. Alfonsín
Christian Meoli as Federico Aranda
Jake Carpenter as Alberto Antuna
Silvio Pollio as Álex Morales
Jason Gaffney as Victor Bolarich
Seth James Arnett as Tomás Alonso
Aurelio Dinunzio as Dr. Solana
Fiona Roeske as Mrs. Solana
based on Piers Paul Read's 1974 book Alive: The Story of the Andes Survivors, which details a Uruguayan rugby team's crash aboard Uruguayan Air Force Flight 571 into the Andes mountains on October 13, 1972.