Abstract The relationship between the Pacific–North American (PNA) teleconnection pattern and Ohio River Valley (ORV) winter precipitation and hydrology is described. The PNA is significantly linked to moisture variability in an area extending from southeastern Missouri, northeastward over states adjacent to the Ohio River through Ohio. Maximum correlation between the PNA index and station precipitation peaks in southern Indiana at r = −0.71, making the circulation/climate teleconnection one of the strongest in the Northern Hemisphere. The North Pacific index (NPI), a Pacific basin sea level pressure index that is highly correlated to the PNA, confirms a strong circulation–ORV precipitation relationship extending back to 1899. In contrast, measures such as the Tahiti–Darwin Southern Oscillation index (SOI) and Nino-3.4 (5°S–5°N, 120°–170°W) sea temperatures are not significantly correlated to ORV winter precipitation. Wettest (driest) winters occur with zonal (meridional) flow with the PNA negative (posit...