Grapevine trunk diseases, caused by a range of phytopathogenic fungi, represent a serious impediment to wine and table grape production wherever these crops are cultivated. Previous studies have shown that the distribution of these pathogens is influenced by climate and that they are associated with a variety of internal wood decay symptoms. Little was known, however, about the influence of climate on the disease symptomatology of the different pathogens in a specific area. To address this, a survey was conductedin 30 wine and table grape vineyards in summer, marginal and winter rainfall regions of South Africa. Apart from Eutypa lata, which occurred only in the winter rainfall region, Phaeomoniella chlamydospora, species of Phaeoacremonium, Botryosphaeriaceae and Phomopsis occurred in all regions surveyed. The incidence of the fungal genera and species associated with trunk disease varied between regions, with overlapping symptom profiles that differed based on the climatic region. These findings suggest that symptom-based disease diagnosis alone is unreliable and that distribution and symptomatology of grapevine trunk pathogens are strongly influenced by climatic conditions in a specific production region.