In this paper we explore a speleothem Î18O record from Palestina cave, northwestern Peru, at a site on the eastern side of the Andes cordillera, in the upper Amazon Basin. The Î18O record is interpreted as a proxy for South American Summer Monsoon (SASM) intensity and allows the reconstruction of its variability during the last 1600 years. Two periods of anomalous changes in the climate mean state corresponding to the Medieval Climate Anomaly (MCA) and the Little Ice Age (LIA) periods identified in the Northern Hemisphere are recognized in the record, in which decreased and increased SASM activity, respectively, have been documented. Variations in SASM activity between the MCA and the LIA seem to be larger over the northern part of the continent, suggesting a latitudinal dependence of the MCA footprint. Our results, based on time series, composite and wavelet analyses, suggest that the Atlantic Multidecadal Oscillation (AMO) plays an relevant role for SASM modulation on multidecadal scales (∼65 years), especially during dry periods such as the MCA. Composite analyses, applied to evaluate the influence of the AMO on the Palestina cave Î18O and other Î18O-derived SASM reconstructions, allow insight into the spatial footprints of the AMO over tropical South America and highlight differences between records during key studied periods. This work also reveals that replicating regional climate signals from different sites, and using different proxies is absolutely essential for a comprehensive understanding of past changes in SASM activity.