Climate is a critical variable in determining the productivity and structural complexity of forest ecosystems. Under similar temperature regimes and other site conditions, precipitation becomes fundamental for forest regeneration and growth, and eventually for the development of structural complexity and patterns in forest productivity. Empirical quantification for this expected response to varying precipitation is needed, especially to provide conservation and management strategies under current and future climate change impacts. To address this need, we evaluated the effects of varying annual precipitation regimes (dry, mesic, and humid sites; all with similar temperature regimes) on three key forest attributes and processes; 1) size and age structure, 2) tree spatial point patterns, and 3) forest stand productivity based on the normalized difference vegetation index (NDVI), in three old-growth lenga (Nothofagus pumilio) forests in western Patagonia. Tree-size and age structure were irregular in the humid and mesic sites, and regular (unimodal) in the dry site (based on Weibull probability function). The relationship between tree diameter and age was strongest in the humid site (r2 = 0.86), and weakest in the dry site (r2 = 0.36). Forest stand productivity was significantly higher in the humid site (mean NDVI = 0.73, vs. 0.68 and 0.63 in the mesic and dry sites, respectively). Univariate spatial-point patterns showed that the humid site had the strongest clumped pattern for live trees along all distances analyzed (i.e., 20 m), while the dry site had a fully random pattern for live and dead trees along all distances analyzed. Collectively, these results illustrate different challenges for silviculture in these forests: 1) The multi-aged structure, plus clumped spatial patterns of small trees (following partial overstory disturbance) in the humid and mesic sites, reflect a gap-based regeneration mode, which consequently suggests the feasibility of implementing uneven-aged silviculture in these sites; 2) Dry sites, close to the forest-steppe ecotone (dry, cool and windy) may require a focus on silviculture for adaptation to cope with expected declines in precipitation and to potentially avoid the loss of these ecosystems to woodlands; 3) Dieback of larger trees in mesic sites (presumably due to xylem cavitation) is a reflection of climate change impacts and a warning to implement strategies that may adapt these forests to new climate conditions (transition to dry condition). Consideration of the great variation in structure and productivity in Patagonian lenga forests due to differences in precipitation regimes, is urgently needed to guide the development of site-specific management approaches for this forest type, particularly given expected future declines in precipitation.