This review paper discusses the physical basis and the potential for decadal climate predictability over the Atlantic and its adjacent land areas. Many observational and modeling studies describe pronounced decadal and multidecadal variability in the Atlantic Ocean. However, it still needs to be quantified to which extent the variations in the ocean drive variations in the atmosphere and over land. In particular, although a clear impact of the Tropics on the midlatitudes has been demonstrated, it is unclear if and how the extratropical atmosphere responds to midlatitudinal sea surface temperature anomalies. Although the mechanisms behind the decadal to multidecadal variability in the Atlantic sector are still controversial, there is some consensus that some of the longer-term multidecadal variability is driven by variations in the thermohaline circulation. The variations in the North Atlantic thermohaline circulation appear to be predictable one to two decades ahead, as shown by a number of perfect model predictability experiments. The next few decades will be dominated by these multidecadal variations, although the effects of anthropogenic climate change are likely to introduce trends. Some impact of the variations of the thermohaline circulation on the atmosphere has been demonstrated in some studies so that useful decadal predictions with economic benefit may be possible.