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Previa stubborn at altitude

In addition to dogging it on the hills, my 1992 Toyota Previa is occasionally hesitant to start when at higher elevation, ~9K’, usually when it’s also hot.

It’s otherwise quite reliable.

Any tips?

I dunno, but I’d probably clean the MAF sensor to see if that does anything. The lower density air would probably alter how it interprets things. If it’s getting numb due to being fouled, cleaning it might fix your issue.

I don’t KNOW this, but it’s where I would start without some intimate knowledge of the effect.