This paper revises paleoenvironmental data from Patagonia (southern South America) to discuss the occurrence, characteristics, and human impact of the Medieval Climatic Anomaly (MCA). The analysis of continuous paleoenvironmental archives with multidecadal-to-centennial resolution is based on a quality assessment regarding data interpretation, chronological control, and time range adequacy within the MCA lapse. After applying this three-stepped quality filters on the total dataset ( N = 48), 18 cases can accurately be ascribed to the MCA. Except for two sites indicating wetter conditions, these records show dry and/or warm conditions between ca. 750 and 1350 CE (core period at ca. 800–1200 CE). Even though MCA records come mostly from forests and forest-steppe ecotones, all previous archeological hypotheses about the MCA effects on past hunter-gatherers were proposed for the steppes, particularly in southern sectors, thus requiring an assessment of the source of the signal, their synchronicity and causality between human-environmental processes. In the southern steppe, paleoenvironmental records partially overlapping with the MCA time window actually show a predominance of wet conditions between 47° and 50° S, whereas a generalized aridity is recorded in southern tip of the continental Patagonia between 51° and 52° S. Thus, a complex scenario of landscape fragmentation can be supported in the southern steppes during the MCA, produced not only by enhanced aridity in dry environments, but also because of the presence of wet and more resilient areas. This landscape heterogeneity must be considered to deepen the understanding of behavioral changes contemporaneous to the MCA. However, a scenario of demographic growth suggested around 1000 CE for the entire Patagonia could have promoted human changes similar to those expected for the MCA. Finally, no-archeological discussions linked to the MCA were developed for forest regions, despite their robust paleoenvironmental records, implying that changes in proxy data might not have necessarily involved important environmental changes.