Streamflow in South-Central Chile (SCC, ∼35° S–42° S) is vital for agriculture, forestry production, hydroelectricity, and human consumption. Recent drought episodes have generated hydrological deficits with damaging effects on these activities. This region is projected to undergo major reductions in water availability, concomitant with projected increases in water demand. However, the lack of long-term records hampers the development of accurate estimations of natural variability and trends. In order to provide more information on long-term streamflow variability and trends in SCC, here we report findings of an analysis of instrumental records and a 296-year tree-ring reconstruction of the summer streamflow of the Río Imperial (∼37°40' S–38°50' S). This is the first reconstruction in Chile targeted at this season. Results from the instrumental streamflow record (∼1940 onwards) indicated that the hydrological regime is fundamentally pluvial with a small snowmelt contribution during spring, and evidenced a decreasing trend, both for the summer and the full annual record. The reconstruction showed that streamflow below the average characterized the post-1980 period, with more frequent, but not more intense, drought episodes. We additionally found that the recent positive phase of the Southern Anular Mode has significantly influenced streamflow. These findings agree with previous studies, suggesting a robust regional signal and a shift to a new hydrological scenario. In this paper, we also discuss the implications of these results for water managers and stakeholders; we provide rationale and examples that support need for the incorporation of tree-ring reconstructions into water resources management.