Medicine Lake volcano (MLV) is a very large shield-shaped volcano located in northern California where it forms part of the southern Cascade Range of volcanoes. It has erupted hundreds of times during its half-million-year history, including nine times during the past 5,200 years, most recently 950 years ago. This record represents one of the highest eruptive frequencies among Cascade volcanoes and includes a wide variety of different types of lava flows and at least two explosive eruptions that produced widespread fallout. Compared to those of a typical Cascade stratovolcano, eruptive vents at MLV are widely distributed, extending 55 km north-south and 40 km east-west. The total area covered by MLV lavas is >2,000 square kilometers, about 10 times the area of Mount St. Helens, Washington. Judging from its long eruptive history and its frequent eruptions in recent geologic time, MLV will erupt again. Although the probability of an eruption is very small in the next year (one chance in 3,600), the consequences of some types of possible eruptions could be severe. Furthermore, the documented episodic behavior of the volcano indicates that once it becomes active, the volcano could continue to erupt for decades, or even erupt intermittently for centuries, and very likely from multiple vents scattered across the edifice. Owing to its frequent eruptions, explosive nature, and proximity to regional infrastructure, MLV has been designated a “high threat volcano” by the U.S. Geological Survey (USGS) National Volcano Early Warning System assessment. Volcanic eruptions are typically preceded by seismic activity, but with only two seismometers located high on the volcano and no other USGS monitoring equipment in place, MLV is at present among the most poorly monitored Cascade volcanoes.