Perception and management of risk by high altitude mountain climbers were investigated by qualitative analysis. Reports of high altitude mountain climbing collected from 3 books and 15 articles from mountaineering magazines were analyzed by the KJ method and transcripts derived from semi-structured interview of 6 distinguished Japanese expert mountain climbers were analyzed by M-GTA. The results indicated the following trends: 1) The desire for more fascinating high altitude mountain climbing routes inevitably leads climbers to face difficult and uncertain situations. 2) Such climbers are highly aware of the uncertainty derived from the high altitude environment and the exertion of climbing. 3) Because they are aware of this uncertainty, their decisions always waver between challenge and safety, and they always attempt to reduce the degree of risk. 4) Such efforts consist of two phases: risk reduction prior to the climb, and on-site avoidance of risk, each being characterized by mental simulation, avoidance of uncontrollable situations, and endeavours to salvage a positive result. 5) After the climb, ambivalent cognition between reflection on their optimism and achievement also emerges. Among all, mental simulation primed by on-site signs of risk, and risk evaluation from the viewpoint of controllability were regarded as keys to staying alive in high risk situations during high altitude mountaineering. Through this risk perception and management process, high altitude climbers possess a contradictory sense of “controllable risk” that enables them to engage in high risk activity. Overall, the characteristics of risk perception and management were similar among the materials obtained from books/magazine articles and interview transcripts. The characteristics of climbers' perception and risk management were rationalized by the characteristics of the natural environment in which they were climbing, and also from the viewpoint of the situated action. The possible application of these findings to risk management in outdoor sports was also discussed.