Quite a few studies have documented the evolution of monsoon synoptic systems and midlatitude atmospheric blocking associated with the recent heavy precipitation and floods over northwest Pakistan during 2010. This period also witnessed a very unusual Indo-Pacific sea surface temperature (SST) evolution with a strong La Niña event in the Pacific, substantial Indian Ocean warming, and a negative Indian Ocean dipole event, together with significant enhancement of precipitation over both the equatorial western Pacific Ocean and the eastern Indian Ocean. Here, the authors perform a suite of high-resolution atmospheric general circulation model experiments to investigate the influence of Indo-Pacific SST anomalies on the South Asian monsoon circulation and heavy precipitation over Pakistan and adjoining northwest India during 2010. The realistic simulation of these rainfall anomalies using observed SSTs motivated the authors to explore the specific influence of Indian Ocean and Pacific SST anomalies through additional simulation experiments. The authors find that, in addition to strengthening of the Pacific Walker circulation, the anomalous intensification of east–west circulation over the Indian Ocean in 2010 was a key element in contributing to precipitation enhancement over the northwest India–Pakistan region. It is found that the subsiding branch of the east–west circulation over the Indian Ocean induced anomalous subsidence over the western tropical Indian Ocean and played a key role in inducing northward transport of moisture and promoting generation of strong upward motion and heavy precipitation events over the northwest India–Pakistan region.