Pleistocene glacial activity was a major influence on runoff and sediment supply in many river systems across the Mediterranean. The geomorphological impacts of changes in sediment supply between glaciated headwater terrains and downstream depocentres spanning several glacial cycles are, however, poorly understood. By applying uranium-series and optically stimulated luminescence dating to fluvial and glacial sediments preserved on Mount Chelmos (2355 m a.s.l.) in southern Greece, we show how changes in the long-term coupling between glacial and fluvial systems are preserved within a major glaciofluvial outwash fan system that functioned during multiple cold stages. We also present evidence in the form of a cemented till unit, stratigraphically below younger Middle Pleistocene glacial deposits, yielding a U-series age close to the limit of the technique, indicating glaciation during Marine Isotope Stage (MIS) 16 - one of the most severe cold stages recorded in the Mediterranean. This is the first time such early glaciation has been directly recorded in Greece and the wider Balkans and is defined here as the Valvousian Stage based on glacial deposits on Mount Chelmos. Geomorphological and geochronological data point to the formation of a more extensive plateau ice field over Chelmos during MIS 12, another severe glacial period in the Balkans that corresponds with the Skamnellian Stage glaciation of Northern Greece. During this phase, very strong coupling of glacial and fluvial systems led to meltwater flood events transferring large volumes of sediment to lower valley zones culminating in the formation of an extensive glaciofluvial outwash fan complex and glaciofluvial terraces. A smaller plateau ice field during MIS 6 and localised valley glaciers between MIS 5d to 5c correlate with the Vlasian and early Tymphian Stage glaciations in Greece, respectively. The delivery of much less meltwater and sediment through a single valley during MIS 6 and MIS 5b to MIS 4 signalled the transition to progressively weaker glacial and fluvial system coupling. After MIS 4 the uncoupling of depositional zones from sediment sources in glaciated catchments led to fluvial incision of glaciofluvial outwash deposits in several valleys. Despite this incision, the glaciofluvial outwash fans preserve a record of glacial and fluvial system interactions during the Middle Pleistocene and early stages of the Late Pleistocene.