Historical extreme storms that struck the Gulf Coast and Atlantic Coast regions of the United States caused several different styles of morphological response and resulted in a wide range of washover penetration distances. The post- storm erosional responses included dune scarps, channel incisions, and washouts, whereas depositional responses included perched fans, washover terraces, and sheetwash lineations. Maximum inland extent of washover penetration ranged from approximately 100 to 1000 m and estimated sediment volumes associated with these deposits ranged from about 10 to 225 m 3/m of beach. Unusual styles of morphological response (sheetwash lineations and incised channels) and maximum washover penetration distances are closely correlated, and they also correspond to storm intensity as denned by the Saffir-Simpson wind-speed scale. The regional morphological responses and washover penetration distances are controlled primarily by the interactions among heights and durations of storm surge relative to adjacent land elevations, differences in water levels between the ocean and adjacent lagoon, constructive and destructive interference of storm waves, and alongshore variations in nearshore bathymetry. For barrier segments that are entirely submerged during the storm, impacts can be enhanced by the combined influences of shallow water depths and organized flow within the wind field. The greatest washover penetrations and sediment accumulations are products of shallow water, confined flow, and high wind stress. Transport and deposition of washover sediments across barrier islands and into the adjacent lagoon are common processes along the Gulf of Mexico but not along the western Atlantic Ocean. This fundamental difference in storm impact underscores how microtidal and mesotidal barriers respond respectively to extreme storms, and provides insight into how different types of barrier islands will likely respond to future extreme storms and to a relative rise in sea level.