Antsirabe is a highland town in Madagascar's central plateau, sitting at 1,500 metres elevation about 170 km south of Antananarivo. The altitude gives it a cooler climate than the coast, and Norwegian missionaries established it as a health resort in the 19th century. Today it is one of Madagascar's busiest market towns and an important centre for the gem trade: street vendors and stalls sell precious and semi-precious stones, and in some places you can watch them being cut and polished.
The most memorable aspect of arriving in Antsirabe is the immediate swarm of pousse-pousse drivers — operators of the rickshaw-like transport that is the town's signature. Competition is fierce and prices are negotiable; choose a young driver if you want to move at any speed. The Our Lady of La Salette Cathedral, a red-brick neo-Gothic landmark with twin towers, anchors the town centre.
The town has several thermal springs; the baths at Lac Ranomafana (the name means "hot water") offer private cubicles and massages at low prices. The countryside beyond is worth a half-day: Lac Andraikiba, 7 km west, is an easy cycle ride and good for swimming; Lac Tritiva, 20 km out, is more scenic but the road is rough and steep — start early. The small Merina village of Betafo is accessible by bicycle or taxi on a flatter road, and gives a sense of rural highland life.
Antsirabe is also a centre for handicrafts: the small shops on the main streets sell good-quality Malagasy artefacts, and bargaining is expected and normal.