Medicine Lake Volcano began to grow about one million years ago in Pleistocene time, following the eruption of a large volume of tholeiitic high-alumina basalt. Similar high-alumina basalt has continued to erupt around the volcano throughout its history. Although mafic lavas predominate on the volcano's flanks, all lava compositions from basalt to rhyolite have erupted during Pleistocene time. The lower flanks consist of mostly basaltic and some andesitic lavas. Basalt is mostly absent at higher elevation, where andesite dominates and rhyolite and small volumes of dacite are present. During the past 11,000 years, eruptive activity at Medicine Lake Volcano has been episodic. Eight eruptions produced about of basaltic lava during a time interval of a few hundred years about 10,500 years ago. That eruptive episode was followed by a hiatus that ended with a small andesitic eruption about 4,300 years ago. During the most recent eruptive episode between 3000 and 900 years ago, eight eruptions produced approximately of lava ranging in composition from basalt to rhyolite. Late Holocene lava compositions include basalt and andesite, but silicic lavas dominate.