Central Chile, home to more than 10 million inhabitants, has experienced an uninterrupted sequence of dry years since 2010 with mean rainfall deficits of 20-40%. The so-called Mega Drought (MD) is the longest event on record and with few analogues in the last millennia. It encompasses a broad area, with detrimental effects on water availability, vegetation and forest fires that have scaled into social and economical impacts. Observations and reanalysis data reveal that the exceptional length of the MD results from the prevalence of a circulation dipole-hindering the passage of extratropical storms over central Chile-characterized by deep tropospheric anticyclonic anomalies over the subtropical Pacific and cyclonic anomalies over the Amundsen-Bellingshausen Sea. El Nino Southern Oscillation (ENSO) is a major modulator of such dipole, but the MD has occurred mostly under ENSO-neutral conditions, except for the winters of 2010 (La Nina) and 2015 (strong El Nino). Climate model simulations driven both with historical forcing (natural and anthropogenic) and observed global SST replicate the south Pacific dipole and capture part of the rainfall anomalies. Idealized numerical experiments suggest that most of the atmospheric anomalies emanate from the subtropical southwest Pacific, a region that has experienced a marked surface warming over the last decade. Such warming may excite atmospheric Rossby waves whose propagation intensifies the circulation pattern leading to dry conditions in central Chile. On the other hand, anthropogenic forcing (greenhouse gases concentration increase and stratospheric ozone depletion) and the associated positive trend of the Southern Annular Mode also contribute to the strength of the south Pacific dipole and hence to the intensity and longevity of the MD. Given the concomitance of the seemingly natural (ocean sourced) and anthropogenic forcing, we anticipate only a partial recovery of central Chile precipitation in the decades to come.