We present paleoclimate evidence for rapid (<100 years) shifts of ∼2-4 °C in Chesapeake Bay (CB) temperature ∼2100, 1600, 950, 650, 400 and 150 years before present (years BP) reconstructed from magnesium/calcium (Mg/Ca) paleothermometry. These include large temperature excursions during the Little Ice Age (∼1400-1900 AD) and the Medieval Warm Period (∼800-1300 AD) possibly related to changes in the strength of North Atlantic thermohaline circulation (THC). Evidence is presented for a long period of sustained regional and North Atlantic-wide warmth with low-amplitude temperature variability between ∼450 and 1000 AD. In addition to centennial-scale temperature shifts, the existence of numerous temperature maxima between 2200 and 250 years BP (average ∼70 years) suggests that multi-decadal processes typical of the North Atlantic Oscillation (NAO) are an inherent feature of late Holocene climate. However, late 19th and 20th century temperature extremes in Chesapeake Bay associated with NAO climate variability exceeded those of the prior 2000 years, including the interval 450-1000 AD, by 2-3 °C, suggesting anomalous recent behavior of the climate system.