Perspectives on past climate using lake sediments are critical for assessing modern and future climate change. These perspectives are especially important for water-stressed regions such as the western United States. One such region is northwestern California (CA), where Holocene-length hydroclimatic records are scarce. Here, we present a 9000-year, relative lake level record from Maddox Lake (CA) using a multi-indicator approach. The Early Holocene is characterized by variably low lake levels with a brief excursion to wetter climates/relative highstand ca. 8.4–8.06 cal ka BP, possibly related to the 8.2 ka cold event and changing Atlantic Meridional Overturning Circulation (AMOC). From 5.2–0.55 cal ka BP, Maddox Lake experienced a long-term regression, tracking changes in summer-winter insolation, tropical and northeast Pacific SSTs, and the southward migration of the ITCZ. This gradual regression culminated in a pronounced relative lowstand during the Medieval Climatic Anomaly (MCA). A marked relative highstand followed the MCA, correlative to the Little Ice Age. The latter reflects a far-field response to North Atlantic volcanism, solar variability, and possibly changes in AMOC and Arctic sea ice extent. Our results further confirm the hydroclimatic sensitivity of northwest California to various forcings including those emanating from the North Atlantic.