Water quality and the culture performance of juvenile rainbow trout (Oncorhynchus mykiss) were evaluated between 2014 and 2017 in a recirculating aquaculture system (RAS) in the Chilean Altiplano. Key parameters such as temperature, total ammonia nitrogen (TAN), nitrates, and dissolved oxygen were monitored, with values ranging from 7 to 21 °C, <0.1 to 0.63 mg/L, 2.0 to 135 mg/L, and 1.8 to 7.5 mg/L, respectively. Additional parameters—including alkalinity, arsenic, chlorine, true color, conductivity, hardness, phosphorus, pH, potassium, suspended solids, and salinity—were also assessed, comparing different points within the system (head tank, culture tanks, and settling tanks). The results showed that water quality remained within acceptable ranges for aquaculture, although fluctuations in pH and low alkalinity levels caused stress in the fish. Despite these challenges, the specific growth rate (SGR) was 1.49, the feed conversion ratio (FCR) was 1.52, and weight gain reached 298.7%, with a survival rate of 96.2%. This study demonstrates that aquaculture in the Altiplano is feasible and can contribute to the sustainable development of aquaculture in the region. Furthermore, it highlights the importance of comprehensive water quality monitoring to optimize RAS performance in challenging environments.