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Abstract A large proportion of western North America experiences regular water stress, compounded by high seasonal and interannual variability. In the Intermountain West region, the El Niño/Southern Oscillation (ENSO) is a critical control on winter precipitation, but the nature of this signal is entangled with a combination of orographic effects and long-term climate trends. This study employs a spatially distributed, nonlinear spline model to isolate ENSO impacts from these other factors using gauge-based observations starting in 1871. In contrast to previous modelling approaches, our approach uses original gauge data, without shortening the record to accommodate a common period. This enables more detailed separation of ENSO effects from the confounding influence of topography and long-term trends, whereas the longer time frame permits more robust correlation with the ENSO signal. Here we show that the complex topography of the Intermountain West exaggerates the underlying ENSO signal, producing a 2.3–5.8 times increase in the range of ENSO-induced precipitation changes along high-elevation western slopes relative to lower elevations. ENSO effects on winter precipitation can be as large as ± 100 mm at high elevations. Further, our approach reveals that the previously recognized dipolar pattern of positive (negative) association of ENSO with precipitation in the south (north) manifests as an incremental relationship in the south but as a near-binary switch in effects between El Niño and La Niña in the north. The location and extent of the strongest precipitation differences vary during the positive and negative ENSO phases within each region. The intricacies of these spatial- and elevation-based modulations of ENSO impacts are especially informative for the northern centre of this dipole, where ENSO-precipitation relationships have previously been difficult to resolve.