Long-term streamflow reconstructions help characterize climate variability and extreme climatic events, such as droughts, which play a crucial role in water resource planning. Dendrohydrological reconstructions generally build on indirect associations between streamflow and radial tree growth, both of which depend on cool season precipitation in the Pacific Northwest. We develop a new approach that integrates a tree ring reconstruction of cool season precipitation with historical meteorological data and a physically based hydrologic model to reconstruct warm season streamflow and streamflow uncertainty. The Upper Yakima Basin in Washington state is used as a test case. We applied objective screening, principal components analysis, and multiple linear regression to reconstruct 366 years of basin-average cool season precipitation. The reconstruction was integrated with five temporally and spatially distributed cool season precipitation patterns spanning the historical range of natural variability. These distributed meteorological reconstructions were used as inputs to the Variable Infiltration Capacity (VIC) hydrologic model over the Yakima basin to produce an ensemble of warm season streamflows for each reconstructed year. The resultant streamflow reconstruction retains dendroclimatic information and quantifies the inherent uncertainty in warm season streamflow associated with historical meteorology. Finally, the meteorological reconstructions were systematically perturbed and used to drive the VIC to examine the potential impacts of climate change on warm season streamflow over the 366-year record. Despite projected wetter conditions in the future, less precipitation is stored as snowpack (due to warmer winter temperatures) and consequently warm season streamflow will be systematically reduced. The combination of long records of variability and systematic changes related to climate change provides useful information about the combined effects of natural variability and projected systematic changes in climate to support 21st-century water planning.