The frequency and duration of Late-Holocene hydrologic extremes in northern Guatemala were investigated using multiple sedimentological and geochemical proxies preserved in a sediment core collected from Lake Petén Itzá. A general trend of increasing aridity in the Maya Lowlands during the past 2000 years was punctuated by several multidecadal- to centennial-scale drought events recorded in the Petén Itzá sediments. In particular, the period spanning the Maya Terminal Classic Period and the Medieval Climate Anomaly (MCA), between 800 and 1300 CE, was marked by several extreme droughts and included the driest conditions of the past 2000 years between 950 and 1100 CE. Similarities between our data and other existing regional paleoclimate records suggest regional drying events during this time may have been driven by a common mechanism. Specifically, comparisons between these records and tropical Atlantic Sea surface temperatures (SSTs) suggest that the dry intervals may have been driven by a westward expansion of the North Atlantic Subtropical High-pressure system. This period was unique in the general agreement between regional proxy records, which are otherwise notably heterogeneous during the Late-Holocene. During the Little Ice Age (LIA; 1400–1800 CE) mean precipitation at Petén Itzá was further reduced, and multidecadal drying events were recorded between 1500–1530, 1600–1640, and 1770–1800 CE. However, regional hydroclimatic coherency was weaker during the LIA, suggesting that additional climatic mechanisms played a more important role in local-scale hydrology during that time.