It is quite widely accepted that the along-shelf pressure gradient (ASPG) contributes in driving shelf currents in the Middle Atlantic Bight (MAB) off the northeastern U.S. coast; its origin, however, remains a subject for debate. Based on analyses of 16 yr (1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) of satellite, tide gauge, river, and wind data and numerical experiments, the authors suggest that river and Coastal Labrador Sea Water (CLSW) transport contribute to a positive mean ASPG (tilt up northward) in the ratio of approximately 1:7 (i.e., CLSW dominates), whereas wind and the Gulf Stream tend to produce a negative mean ASPG in the ratio of approximately 1:6.Data also indicate seasonal and interannual variations of ASPG that correlate with the Gulf Stream's shift and eddy kinetic energy north of the Gulf Stream (N-EKE) due to warm-core rings. A southward shift in the Gulf Stream produces a sea level drop north of Cape Hatteras, which is most rapid in winter. The N-EKE peaks in late spring to early summer and is larger in some years than others. A process model is used to show that ring propagation along the MAB slope and ring impingement upon the shelf break north of Cape Hatteras generate along-isobath density gradients and cross-shelfbreak transports that produce sea level change on the shelf; the dominant ageostrophic term in the depth-integrated vorticity balance is the joint effect of baroclinicity and relief (JEBAR) term. In particular, the shelf's sea surface slopes down to the north when rings approach Cape Hatteras.