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The climate of South America (SA) has long held an intimate connection with El Niño, historically describing anomalously warm sea-surface temperatures off the coastline of Peru. Indeed, throughout SA, precipitation and temperature exhibit a substantial, yet regionally diverse, relationship with the El Niño–Southern Oscillation (ENSO). For example, El Niño is typically accompanied by drought in the Amazon and north-eastern SA, but flooding in the tropical west coast and south-eastern SA, with marked socio-economic effects. In this Review, we synthesize the understanding of ENSO teleconnections to SA. Recent efforts have sought improved understanding of ocean–atmosphere processes that govern the impact, inter-event and decadal variability, and responses to anthropogenic warming. ENSO’s impacts have been found to vary markedly, affected not only by ENSO diversity, but also by modes...