While American Express (Amex) is accepted at over 44 million merchants globally in 2026, there are several regions and specific countries where its acceptance remains significantly lower than Visa or Mastercard. Generally, countries with a high density of small, cash-preferring businesses or those with lower tourism infrastructure—such as many parts of Mainland China (outside major hotels), Germany, and local markets in Southeast Asia—can be challenging for Amex users. The primary reason is the higher merchant "interchange fees" Amex charges. Even in high-acceptance countries like Australia or the UK, many government agencies, discount retailers (like ALDI or Costco in many regions), and local family-owned "tascas" or "izakayas" may decline it. To ensure you aren't stranded, the "gold standard" travel tip for 2026 is to always carry a "no-foreign-transaction-fee" Visa or Mastercard as a backup, particularly when traveling through rural Europe, South America, or the Middle East where Amex is often limited to luxury hotels and high-end retail.