Background: Peru had the highest COVID-19 accumulated mortality rate worldwide. Previous studies reported the influence of environmental factors such as latitude on COVID-19 cases and deaths. However this relationship is until now not fully established. Aims and objectives: Assess the relationship between latitude and COVID-19 mortality rate and case incidence in Peru at a district level from March 6th, 2020, to February 28th, 2022 and in its 3 waves. Methods: Ecological analytical study examining open data. 1874 Peruvian districts, ranging from -0.38 to -18.23 degrees, with 3 372 962 COVID-19 cases and 212 017 deaths were analyzed. Correlation statistics and a multivariate linear regression model were used to assess this relationship adjusted to altitude, population density and other relevant variables during the pandemic and in 3 arbitrarily defined waves. Results: A negative coefficient of -0.0153 (95% CI -0.024635 to -0.005977) between latitude and mortality rate was obtained during the second wave, corresponding to a 1.54% mortality rate decrease for each degree of proximity to the Equator. A similar correlation with a coefficient of -0.00632 (95% CI -0.010108 to -0.00254) for the third wave was observed, equivalent to a 0.63% mortality rate decrease. In regard to the latitude and case incidence, a coefficient of -0.0224 (95% CI -0.0371327 to -0.007709) during the third wave was obtained, representing a 2.27% case incidence decrease for each degree of proximity to the Equator. Conclusions: Latitude may have a protective effect against COVID-19 mortality rate and case incidence. More studies are needed to assess this relationship.