We examine the upper tail of flood peak distributions through analyses of annual peak observations from more than 8,000 U.S. Geological Survey (USGS) stream gaging stations and through hydrometeorological analyses of the storms that produce the most extreme floods. We focus on the distribution of the upper tail ratio, which is defined as the peak discharge for the flood of record at a stream gaging station divided by the sample 10‐year flood magnitude. The 14 June 1903 Heppner storm, which produced an upper tail ratio of 200, was the product of a hailstorm that formed along the Blue Mountains in eastern Oregon, a region dominated by snowmelt flooding. A striking contrast between record flood peaks and the larger distribution of annual flood peaks in the United States is in the seasonality of flood occurrence, with record floods reflecting a much stronger contribution from warm season thunderstorm systems. Mountainous terrain and intense convective rainfall are important elements of the geography and hydrometeorology of extreme upper tail ratio flood peaks. The distribution of upper tail ratio values for USGS stream gaging stations does not depend on basin area, a result which is consistent with scaling results based on extreme value theory. Downscaling simulations with the Weather Research and Forecasting model are used to examine the storm environment of the 1903 Heppner storm, along with two other record flood peaks near the Blue Mountains of eastern Oregon from the USGS miscellaneous flood record, the July 1956 Meyers Canyon flood and the July 1965 Lane Canyon flood.