Abstract The West African monsoon (WAM) is a vital source of rainfall for the African Sahel. In addition to the agricultural benefit of its rains, it benefits public health because bacterial meningitis outbreaks end with the monsoon onset. Outbreaks occur between December and May, a period of low humidity. Knowledge of the onset of high humidity could aid in predicting where the outbreaks will cease. Therefore, this study investigates the variability of atmospheric moisture during the spring over West Africa, characterizing the sources of moisture, as well as circulation patterns and relative influences of tropical and midlatitude systems. A conceptual model of the evolution of the premonsoon period is presented. The meridional and temporal variability of surface moisture during the spring is modulated by multiscale interactions, as illustrated for the period from mid-April to early May 2009. As westward-propagating, synoptic disturbances move across West Africa, a corresponding peak occurs in the surface relative humidity. With the passage of each disturbance a new and more humid regime is established. Filtered anomalies of outgoing longwave radiation (OLR) indicate that Kelvin waves, equatorial Rossby waves, and possibly the MJO contributed to the initiation and intensification of the synoptic disturbances. During the last of the disturbances, whose passage raised the relative humidity above 40%, a critical threshold for meningitis, an extratropical cyclone also contributed to moisture influx over the Sahel. Analysis of the period 2000–09 shows the relative influences of synoptic and subseasonal circulations on the onset of high relative humidity over the Sahel during the spring.