The 71-year-old ex-Beatle's performance in Quito at an altitude of 9,350 feet (2,850 meters) included a special rendition on piano of "All You Need is Love," which the Andean nation is currently using in a global tourism campaign.
The South American leg of McCartney's "Out There" tour has included performances in Uruguay, Chile, Peru and Costa Rica.
McCartney performed for nearly three hours in Quito on Monday night.
He's performed in the past at high-altitude venues such as Bogota, Colombia, and Mexico City.
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