Flood is among the deadliest disasters in India, and the frequency of floods and extreme precipitation events is projected to increase under the warming climate. The frequency of floods in India varies geographically as some regions are more prone to floods than the others. The Kerala flood of 2018 caused enormous economic damage, affected millions of people, and resulted in the death of more than 400 people. Here we provide a hydroclimatological perspective on the Kerala flood of 2018. Using the observations and model simulations from the Variable Infiltration Capacity (VIC) model, we show that the 2018 extreme precipitation and runoff conditions that caused flooding were unprecedented in the record of the past 66 years (1951–2017). Our results show that mean monsoon precipitation has significantly declined while air temperature has significantly increased during 1951–2017 in Kerala. The drying and warming trends during the monsoon season resulted in a declined total runoff in large part of the state in the last 66 years. Apart from the mean hydroclimatic conditions, extreme precipitation, and extreme total runoff have also declined from 1951 to 2017. However, 1 and 2-day extreme precipitation and extreme runoff conditions in August 2018 exceeded substantially from the long-term 95th percentiles recorded during 1951–2017. Since there is no increase in mean and extreme precipitation in Kerala over the last six decades, the extreme event during August 2018 is likely to be driven by anomalous atmospheric conditions due to climate variability rather anthropogenic climate warming. The severity of the Kerala flood of 2018 and the damage caused might be affected by several factors including land use/land cover change, antecedent hydrologic conditions, reservoir storage and operations, encroachment of flood plains, and other natural factors. The impacts of key drivers (anthropogenic and natural) on flood severity need to be established to improve our understanding of floods and associated damage.