This paper examines the long-term historical changes in frequency and amplitude of hydroclimatic extremes in the Blue Nile basin using data from the second half of 20th century. The temporal variability of basin-wide rainfall extremes and river flow extremes from four gauging stations was investigated under the hypothesis of no trend and no persistence in time. On the basis of a quantile anomaly analysis method, decadal variations in extreme daily, monthly, and annual quantiles were studied, and the periods of statistical significance were identified. The analysis showed that high and low river flows and rainfall depths do not vary in time in a fully random way but show a particular variation pattern. Their extremes show significant decadal variations. The 1980s had statistically significant negative anomalies in extremes in comparison with the long-term reference period of 1964–2009, while the 1960s–1970s and the 1990s–2000s had positive anomalies, although less significant. There is neither consistent increasing nor decreasing trend in rainfall and flow extremes of recent years. Therefore, anticipated trends due to global warming could not be identified. Conversely, low-flow extremes show an increasing trend during the last decade, which could be related to the effect of water regulation works at the outlet of Lake Tana. Moreover, similar patterns and statistically significant correlations were found between climatic indices representing the Pacific and Atlantic Oceans and the Blue Nile rainfall and flow extremes. Changes that occur on the Pacific Ocean appear to be a main driver for the decadal oscillations in climate and related high and low Blue Nile water availability for Ethiopia, Sudan, and Egypt.