In August 2022, Pakistan experienced unprecedented monsoon rains, leading to devastating floods and landslides affecting millions. While previous research has mainly focused on the contributions of seasonal and synoptic anomalies, this study elucidates the dominant influences of tropical and extratropical intraseasonal oscillations on both the occurrence and subseasonal prediction of this extreme rainfall event. Our scale-decomposed moisture budget analysis revealed that intense rainfall in Pakistan was triggered and sustained by enhanced vertical moisture transport anomalies, primarily driven by interactions between intraseasonal circulation anomalies and the prevailing background moisture field when tropical and mid-latitude systems coincided over Pakistan. Evaluation of subseasonal-to-seasonal prediction models further highlighted the critical role of tropical intraseasonal modes in causing this extreme rainfall event in Pakistan. Models that accurately predicted northward-propagating intraseasonal convection with a forecast lead time of 8–22 days demonstrated good skill in predicting the extreme event over Pakistan.