The Medieval Climate Anomaly (MCA) is a climatic perturbation with a core period of 1000-1200 AD that is well-recognized in the Northern Hemisphere (NH). Its existence in the Southern Hemisphere (SH) and the level of synchronicity with the NH is still a matter of debate. Here we present a palaeotemperature synthesis for South America encompassing the past 1500 years based on multiproxy data from 76 published land and marine sites. The data sets have been thoroughly graphically correlated and the MCA trends palaeoclimatologically mapped. The vast majority of all South American land sites suggest a warm MCA. Andean vegetation zones moved upslope, glaciers retreated, biological productivity in high altitude lakes increased, the duration of cold season ice cover on Andean lakes shortened, and trees produced thicker annual rings. Similar MCA warming occurred in coastal seas, except in the year-round upwelling zones of Peru, northern Chile and Cabo Frio (Brazil) where upwelling processes intensified during the MCA due to changes in winds and ocean currents. MCA warming in South America and the NH appears to have occurred largely synchronous, probably reaching comparable intensities. Future studies will have to address major MCA data gaps that still exist outside the Andes in the central and eastern parts of the continent. The most likely key drivers for the medieval climate change are multi-centennial Pacific and Atlantic ocean cycles, probably linked to solar forcing.