Tree-ring reconstructed summer Palmer Drought Severity Indices (PDSI) are used to identify decadal droughts more severe and prolonged than any witnessed during the instrumental period. These "megadroughts" are identified at two spatial scales, the North American continental scale (exclusive of Alaska and boreal Canada) and at the sub-continental scale over western North America. Intense decadal droughts have had significant environmental and socioeconomic impacts, as is illustrated with historical information. Only one prolonged continent-wide megadrought during the past 500 years exceeded the decadal droughts witnessed during the instrumental period, but three megadroughts occurred over the western sector of North America from A.D. 1300 to 1900. The early 20th century pluvial appears to have been unmatched at either the continental or sub-continental scale during the past 500 to 700 years. The decadal droughts of the 20th century, and the reconstructed megadroughts during the six previous centuries, all covered large sectors of western North America and in some cases extended into the eastern United States. All of these persistent decadal droughts included shorter duration cells of regional drought (sub-decadal ≈ 6 years), most of which resemble the regional patterns of drought identified with monthly and annual data during the 20th century. These well-known regional drought patterns are also characterized by unique monthly precipitation climatologies. Intense sub-decadal drought shifted among these drought regions during the modern and reconstructed multi-year droughts, which prolonged large-scale drought and resulted in the regimes of megadrought.