The 2015/2016 El Ni.o has been classified as one of the three most severe on record. El Nino teleconnections are commonly associated with droughts in southern Africa and high precipitation in eastern Africa. Despite their relatively frequent occurrence, evidence for their hydrological effects and impacts beyond agriculture is limited. We examine the hydrological response and impact pathways of the 2015/2016 El Ni.o in eastern and southern Africa, focusing on Botswana, Kenya, and Zambia. We use in situ and remotely sensed time series of precipitation, river flow, and lake levels complemented by qualitative insights from interviews with key organizations in each country about awareness, impacts, and responses. Our results show that drought conditions prevailed in large parts of southern Africa, reducing runoff and contributing to unusually low lake levels in Botswana and Zambia. Key informants characterised this El Ni.o through record high temperatures and water supply disruption in Botswana and through hydroelectric load shedding in Zambia. Warnings of flood risk in Kenya were pronounced, but the El Ni.o teleconnection did not materialize as expected in 2015/2016. Extreme precipitation was limited and caused localized impacts. The hydrological impacts in southern Africa were severe and complex, strongly exacerbated by dry antecedent conditions, recent changes in exposure and sensitivity and management decisions. Improved understanding of hydrological responses and the complexity of differing impact pathways can support the design of more adaptive, region-specific management strategies.