Total water levels (TWLs) at the coast are driven by a combination of deterministic (e.g., tides) and stochastic (e.g., waves, storm surge, and sea level anomalies) processes. The contribution of each process to TWLs varies depending on regional differences in climate and framework geology, as well as local-scale variations in beach morphology, coastal orientation, and shelf bathymetry. Large-scale changes to the climate altering the frequency, direction, and intensity of storms, may therefore propagate to the nearshore differently, amplifying or suppressing local coastal hazards and changing the exposure of coastal communities to extreme TWLs. This study investigates the hydrodynamic and geomorphologic factors controlling local TWLs along high-energy United States coastlines where wave-influences dominate TWLs. Three study sites in the states of Washington, Oregon, and California are chosen to explore how regional and local differences in beach topography and wave transformation over shelf bathymetry drives variations in the magnitude and impacts of extreme TWLs. Results indicate that TWLs are most influenced by wave transformation processes in locations with steep beach slopes (which drive larger relative contributions of wave runup) and complex offshore bathymetry, while beach topography influences the severity of coastal impacts. Once the relative morphologic controls on TWLs are better understood, hypothetical future climate scenarios are explored to assess how changes to the average deepwater wave climate (height, period, and direction) may alter local TWLs when compared to estimates of likely sea level rise and future coastal management strategies. Changes to the wave climate are found to be as detrimental to the coastline as sea level rise in some locations, where small variations of the TWL drive large, nonlinear changes in hours of impact to the backshore beach. Overall, this study develops an approach for quantifying the range of hydrodynamic and morphologic controls on the magnitude of TWLs which will ultimately better prepare coastal communities for uncertain changes to the global climate.