Regional droughts are common in North America, but pan-continental droughts extending across multiple regions, including the 2012 event, are rare relative to single-region events. Here, the tree-ring-derived North American Drought Atlas is used to investigate drought variability in four regions over the last millennium, focusing on pan-continental droughts. During the Medieval Climate Anomaly (MCA), the central plains (CP), Southwest (SW), and Southeast (SE) regions experienced drier conditions and increased occurrence of droughts and the Northwest (NW) experienced several extended pluvials. Enhanced MCA aridity in the SW and CP manifested as multidecadal megadroughts. Notably, megadroughts in these regions differed in their timing and persistence, suggesting that they represent regional events influenced by local dynamics rather than a unified, continental-scale phenomena. There is no trend in pan-continental drought occurrence, defined as synchronous droughts in three or more regions. SW, CP, and SE (SW+CP+SE) droughts are the most common, occurring in 12 percent of all years and peaking in prevalence during the twelfth and thirteenth centuries; patterns involving three other regions occur in about 8 percent of years. Positive values of the Southern Oscillation index (La Nina conditions) are linked to SW, CP, and SE (SW+CP+SE) droughts and SW, CP, and NW (SW+CP+NW) droughts, whereas CP, NW, and SE (CP+NW+SE) droughts are associated with positive values of the Pacific decadal oscillation and Atlantic multidecadal oscillation. While relatively rare, pan-continental droughts are present in the paleo record and are linked to defined modes of climate variability, implying the potential for seasonal predictability. Assuming stable drought teleconnections, these events will remain an important feature of future North American hydroclimate, possibly increasing in their severity in step with other expected hydroclimate responses to increased greenhouse gas forcing
