A 136-m-long drill core of sediments was recovered from tropical high-altitude Lake Titicaca, Bolivia-Peru, enabling a reconstruction of past climate that spans four cycles of regional glacial advance and retreat and that is estimated to extend continuously over the last 370,000 yr. Within the errors of the age model, the periods of regional glacial advance and retreat are concordant respectively with global glacial and interglacial stages. Periods of ice advance in the southern tropical Andes generally were periods of positive water balance, as evidenced by deeper and fresher conditions in Lake Titicaca. Conversely, reduced glaciation occurred during periods of negative water balance and shallow closed-basin conditions in the lake. The apparent coincidence of positive water balance of Lake Titicaca and glacial growth in the adjacent Andes with Northern Hemisphere ice sheet expansion implies that regional water balance and glacial mass balance are strongly influenced by global-scale temperature changes, as well as by precessional forcing of the South American summer monsoon. © 2007 University of Washington.