In the summer of 2022, a long-lasting La Niña entered its third year. In Asia, southern China was in the grip of a historic drought while heavy rainfall ravaged Pakistan. Using a climate model forced by observed sea surface temperatures (SST) over the equatorial Pacific, we show that the back-to-back La Niña events from 2020 to 2022 are a key contributor to the global SST pattern in 2022 including the negative phase of Pacific decadal oscillation and exceptionally strong negative Indian Ocean dipole. The model reproduces the observed precipitation pattern over South and East Asia, including enhanced rainfall over Pakistan–northwest India and reduced rainfall over southern China. Additional model simulations indicate that the negative Indian Ocean dipole combined with La Niña can decrease southern China rainfall by causing anomalous subsidence and anticyclonic flows. These results highlight the dominant role of long-lasting La Niña in modulating rainfall over heavily populated monsoon Asia.