Atlantic tropical cyclone activity, as measured by annual storm counts, reached anomalous levels over the past decade. The short nature of the historical record and potential issues with its reliability in earlier decades, however, has prompted an ongoing debate regarding the reality and significance of the recent rise. Here we place recent activity in a longer-term context by comparing two independent estimates of tropical cyclone activity over the past 1,500 years. The first estimate is based on a composite of regional sedimentary evidence of landfalling hurricanes, while the second estimate uses a previously published statistical model of Atlantic tropical cyclone activity driven by proxy reconstructions of past climate changes. Both approaches yield consistent evidence of a peak in Atlantic tropical cyclone activity during medieval times (around ad 1000) followed by a subsequent lull in activity. The statistical model indicates that the medieval peak, which rivals or even exceeds (within uncertainties) recent levels of activity, results from the reinforcing effects of La-Niña-like climate conditions and relative tropical Atlantic warmth.