Paleohydrologic reconstructions of water-year streamflow for 105 sites across the western United States (West) were used to compute the likelihood (risk) of regime (wet/dry state) shifts given the length of time in a specific regime and for a specified time in the future. The spatial variability of risks was examined and indicates that regime shift risks are variable across the West. The Pacific-Northwest region is associated with low risks of regime shifts, indicating persistence controlled by prevalent low frequency variability in flow (periods above 64 years). Other areas in the West indicate higher risks compared to the Pacific-Northwest due to flow variability in the mid-to-high frequencies (periods of 32 to 16 years). Understanding risks of regime shifts provides critical information for improved management of water supplies, particularly during periods of extended low flows. The method presented here has global applicability as a decision-making framework for risk-based planning and management.