The relationships between forest dynamics and climate are predictable for high-altitude forest ecosystems in western North America and other mountainous regions. The duration of snowpack interacts with spring and summer temperature to determine when a snowfree soil surface and sufficiently high soil temperatures for physiological activity occur. Regeneration of tree seedlings varies spatially and temporally as mediated by the duration of the snowpack, which affects the length of the growing season on high-precipitation sites and the soil moisture supply on low-precipitation sites. Regeneration is favoured by climatic conditions that produce a mesic soil moisture regime rather than extremes and by summer temperatures that are sufficiently high to facilitate carbon gain in seedlings. Relatively short-term climatic trends can have major impacts on regeneration patterns, particularly after disturbances. Tree growth in high-snowfall environments (under a marine climate and near the treeline) is generally limited more by precipitation than by temperature, with growth being negatively correlated with snowpack depth. There are many sources of spatial and temporal variation in growth response to climate, most of which are not included in modeling efforts at large spatial scales. Growth response varies between species and within species, depending on subregional climate (high vs. low precipitation in the same mountain range), altitude (treeline vs. lower elevation), aspect (north vs. south) and genotype. The effects of climatic variation on high-altitude forests are distinct from effects in low-altitude ecosystems, and models based on low-altitude forests are not necessarily applicable at higher altitudes. The potential for vegetational inertia—long lag times in response to environmental variation—needs to be considered when evaluating the response of high-altitude forests to climatic change.