God created His creatures to reproduce and fill the earth. As they do so, numerous challenges are faced in different environments, requiring creatures to adapt. High altitudes present serious challenges for endotherms, including a reduced partial pressure of oxygen. Through a variety of mechanisms, many creatures adapt quite successfully to this hytpoxia. Adaptation includes immediate, short-term responses followed by longer-term, more sustainable responses. For mammals and birds that have lived for generations at high altitudes, genetic changes have been identified, reflecting a more permanent response. The neoDarwinian model does not account for the observed phenotypic and genetic changes. Instead, this adaptation is clear evidence of the care God bestows upon His creatures, even in our current fallen world.