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Abstract Extreme stratospheric wave activity has been linked to surface cold extremes over North America, but little is known whether the Quasi-biennial Oscillation (QBO) plays a role in this linkage. Here, by comparing strong stratospheric wave events during the westerly phase (wQBO) with those during the easterly phase (eQBO), we show that the cooling signature following strong wave events depends on the QBO phase in observations. During wQBO, strong wave events are followed by an increased risk of North American cold extremes and a vertical structure shift from a westward phase tilt to an eastward tilt. However, strong wave events under eQBO do not change the cold risk nor alter the vertical tilt. We further examine this dependence on QBO in QBO-resolving climate models, finding that the cooling signature of strong wave events in models is largely insensitive to QBO phases. This insensitivity is suggested to be linked to model biases in the stratospheric wave representation.