Many ecosystem processes that influence Earth system feedbacks, including vegetation growth, water and nutrient cycling, and disturbance regimes, are strongly influenced by multi-decadal to millennial-scale variations in climate that cannot be captured by instrumental climate observations. Paleoclimate information is therefore essential for understanding contemporary ecosystems and their potential trajectories under a variety of future climate conditions. With the exception of fossil pollen records, there are a limited number of northeastern US (NE US) paleoclimate archives that can provide constraints on its temperature and hydroclimate history. Moreover, the records that do exist have not been considered together. Tree-ring data indicate that the 20th century was one of the wettest of the past 500 years in the eastern US (Pederson et al., 2014), and lake-level records suggest it was one of the wettest in the Holocene (Newby et al., 2014); how such results compare with other available data remains unclear, however. Here we conduct a systematic review, assessment, and comparison of paleotemperature and paleohydrological proxies from the NE US for the last 3000 years. Regional temperature reconstructions are consistent with the long-term cooling trend (1000 BCE–1700 CE) evident in hemispheric-scale reconstructions, but hydroclimate reconstructions reveal new information, including an abrupt transition from wet to dry conditions around 550–750 CE. NE US paleo data suggest that conditions during the Medieval Climate Anomaly were warmer and drier than during the Little Ice Age, and drier than today. There is some evidence for an acceleration over the past century of a longer-term wetting trend in the NE US, and coupled with the abrupt shift from a cooling trend to a warming trend from increased greenhouse gases, may have wide-ranging implications for species distributions, ecosystem dynamics, and extreme weather events. More work is needed to gather paleoclimate data in the NE US, make inter-proxy comparisons, and improve estimates of uncertainty in the reconstructions.