The evidence for anthropogenic climate change continues to strengthen, and concerns about severe weather events are increasing. As a result, scientific interest is rapidly shifting from detection and attribution of global climate change to prediction of its impacts at the regional scale. However, nearly everything we have any confidence in when it comes to climate change is related to global patterns of surface temperature, which are primarily controlled by thermodynamics. In contrast, we have much less confidence in atmospheric circulation aspects of climate change, which are primarily controlled by dynamics and exert a strong control on regional climate. Model projections of circulation-related fields, including precipitation, show a wide range of possible outcomes, even on centennial timescales. Sources of uncertainty include low-frequency chaotic variability and the sensitivity to model error of the circulation response to climate forcing. As the circulation response to external forcing appears to project strongly onto existing patterns of variability, knowledge of errors in the dynamics of variability may provide some constraints on model projections. Nevertheless, higher scientific confidence in circulation-related aspects of climate change will be difficult to obtain. For effective decision-making, it is necessary to move to a more explicitly probabilistic, risk-based approach.