The Polar Pennsylvania State University–National Center for Atmospheric Research Fifth-Generation Mesoscale Model (Polar MM5) regional climate model was run over the North Atlantic region for 1991–2000. We analyze 24-km output over the Greenland ice sheet to evaluate spatial and temporal variability of the surface mass balance and its subcomponents. The model output is compared with 3 years of automatic weather station (AWS) data from 17 sites to identify biases. Using the in situ data, we derive simple corrections for biases in melt energy and in water vapor fluxes from the surface and from blowing snow. The simulated accumulation rate is in agreement with AWS and snow pit observations. Estimates for runoff and the surface mass balance distribution over the ice sheet are produced using modeled melt volume and a meltwater retention scheme. From the decade investigated, the magnitude of interannual variability in surface mass balance components is tentatively established. The largest variability is concentrated along the ice sheet margin, where both accumulation and ablation rates are largest. The simulated interannual fluctuations suggest a large absolute variability, ±187 km3 yr−1 for total ice sheet surface mass balance. Variability in simulated equilibrium line altitude is suggestive of a dominance of thermal variability in the south with increasing importance of accumulation variability with increasing latitude. Empirical functions for the sensitivity of surface mass balance to temperature and precipitation anomalies are presented. The precise locations and regions of maximum and minimum surface energy and mass fluxes are suggested. Using an estimate for iceberg discharge and bottom melting, the total ice sheet mass balance is estimated be −78 km3 yr−1, producing 2.2 mm of eustatic sea level rise over the 1991–2000 decade and contributing 15% to the observed (1.5 mm yr−1) global sea level rise. The more negative mass balance is attributed to including blowing-snow sublimation loss and to regional warming in the 1990s.