The atmosphere of caves is a special environment where it is necessary to take into account some particular characteristics when assessing the radon dose. The equilibrium factor (F) between radon and its progeny, and especially its unattached fraction (f p), is a key parameter in radon dose evaluation. In order to consider the specific features of the atmosphere in the Altamira Cave, the radon and particle concentrations have been measured. The mean annual radon concentration inside the cave over the period 2013-2019 is around 3500 Bq m-3 with a standard deviation of 1833 Bq m-3 and this exhibits seasonal variations. This value surpasses all international (WHO, IAEA, ICRP) upper action and reference levels (occupational and non-occupational). Dose rate levels expressed in μSv h-1 were estimated for four different equilibrium scenarios between radon and its progeny 218Po, 214Pb, 214Bi and 214Po. The most recent dose conversion factors have been used and the contribution made to the dose by the unattached fraction of radon progeny f p has been also assessed from the particle concentration. The results suggest that the mean annual dose levels show variations of up to 500% due to the range of F and the f p considered in this study. Given the high radon concentrations usually found in show caves, the best way to reduce this variability and its associated uncertainty in dose assessment is to conduct specific studies aimed at determining both F and f p.