Although drought is a natural part of climate across the north central United States, how drought is experienced and responded to is the result of complex biophysical and social processes. Climate change assessments indicate drought impacts will likely worsen in the future, which will further challenge decision-making. Here, a drought management decision typology is empirically developed from synthesis of three in-depth case studies using a modified grounded theory approach. The typology highlights: a) the entity or entities involved; b) management sectors; c) decision types; d) spatial and temporal scale(s) of decision-making; and e) barriers that inhibit decision-making. Findings indicate similarities in decision types and barriers across cases. Changes in operations, practices, or behaviors; information and technology; and legal or policy changes were the most common decision types, while commonly cited barriers were institutional constraints, fragmented decision-making, and limited personnel and financial resources. Yet, barriers and responses also differed within and between sectors and jurisdictions. Several barriers inhibited anticipatory, regional, and interagency drought response, such as limited institutional support, competing mandates, limited resources, lack of usable information, limits to inter-agency fund transfers, and historical context and distrust among entities. Findings underscore the importance of documenting nuanced decision-making in local places and broader generalizations in decision-making across scales. This contributes to the goal of developing drought science that is actionable for decision-making.