Abstract Extreme snow ablation can greatly impact regional hydrology, affecting streamflow, soil moisture, and groundwater supplies. Relatively little is known about the climatology of extreme ablation events in the eastern United States, and the causal atmospheric forcing mechanisms behind such events. Studying the Susquehanna River basin over a 50-yr period, here we evaluate the variability of extreme ablation and river discharge events in conjunction with a synoptic classification and global-scale teleconnection pattern analysis. Results indicate that an average of 4.2 extreme ablation events occurred within the basin per year, where some 88% of those events resulted in an increase in river discharge when evaluated at a 3-day lag. Both extreme ablation and extreme discharge events occurred most frequently during instances of southerly synoptic-scale flow, accounting for 35.7% and 35.8% of events, respectively. However, extreme ablation was also regularly observed during high pressure overhead and rain-on-snow synoptic weather types. The largest magnitude of snow ablation per extreme event occurred during occasions of rain-on-snow, where a basinwide, areal-weighted 5.7 cm of snow depth was lost, approximately 23% larger than the average extreme event. Interannually, southerly flow synoptic weather types were more frequent during winter seasons when the Arctic and North Atlantic Oscillations were positively phased. Approximately 30% of the variance in rain-on-snow weather type frequency was explained by the Pacific–North American pattern. Evaluating the pathway of physical forcing mechanisms from regional events up through global patterns allows for improved understanding of the processes resulting in extreme ablation and discharge across the Susquehanna basin. Significance Statement The purpose of this study is to better understand how certain weather patterns are related to extreme snowmelt and streamflow events and what causes those weather patterns to vary with time. This is valuable information for informing hazard preparation and resource management within the basin. We found that weather patterns with southerly winds were the most frequent patterns responsible for extreme melt and streamflow, and those patterns occurred more often when the Arctic and North Atlantic Oscillations were in their “positive” configuration. Future work should consider the potential for these patterns, and related impacts, to change over time.