Abstract This study examined the atmospheric circulation patterns that were responsible for the severe flooding that occurred in Pakistan in 2022. It focused on the role of westward-propagating tropical disturbances (TDs) along the South Asian monsoon trough, which are associated with flood-related precipitation events. The study also investigated the interannual precipitation variation in Pakistan over 23 years from 2000 to 2022, using satellite-derived precipitation and atmospheric reanalysis. The results showed high precipitation in southern and central Pakistan, implying tropical influences. The precipitation was the highest in the past 23 years. The massive rainfall was brought by several TDs under the highest water vapor conditions, although a TD of South Asia climatologically tends to weaken before affecting Pakistan. Enhanced easterlies along the Indo-Gangetic Plain, part of the enhanced monsoon trough, supported high water vapor conditions over Pakistan. The high water vapor was also partly supported by the long-lasting active phase of the South Asian monsoon intraseasonal oscillation in 2022. Moreover, the La Niña condition increased moisture transport as a background. On an interannual time scale, the enhanced moisture flux over the Indo-Gangetic Plain resulted in higher precipitation over Pakistan, as occurred in 2022. These high (low) water vapor and precipitation can be partly explained by La Niña (El Niño). However, La Niña and El Niño may not control the TD activity over South Asia. Thus, for 2022, the high water vapor is somewhat empirically predictable, but the active TD activity can be coincidental. Significance Statement In 2022, Pakistan was hit by catastrophic flooding that affected 15% of the population. The analysis of the atmospheric circulation associated with the flooding indicates that weak but rain-bearing tropical disturbances played a significant role in flooding. Several tropical disturbances stayed or moved into Pakistan, bringing massive rainfall although, usually, they tend to weaken before hitting Pakistan. In the past 23 years, La Niña–related weather patterns have partly explained the year-to-year precipitation variation in Pakistan. However, in 2022, the unusually heavy flooding was due to the combined La Niña effect and tropical disturbance activity. Because it is still difficult to predict the seasonal tropical disturbance activity from La Niña, El Niño, and other climatic conditions, seasonal prediction of these floods remains challenging.