Regional-scale surface-level ozone concentrations are linked to meteorological conditions including high temperatures, PBL stagnation, high solar insolation, and low humidity. Such conditions are known to occur together with certain large (synoptic and greater) scale meteorological patterns. This research adopts methods from studies of regional heat waves to identify large-scale meteorological patterns that may precede and coincide with extreme regional ozone pollution episodes in summertime North America. Ozone pollution episodes are identified in almost 40 years of in-situ measurements from the United States Air Quality System (AQS) and the Canadian National Air Pollution Surveillance Program (NAPS). AQS and NAPS stations are grouped into regions likely to experience simultaneous extreme ozone concentrations using statistical clustering methods. Composite meteorological patterns are then calculated for multi-day periods of region-wide extreme ozone concentrations. These patterns exhibit local meteorological conditions expected alongside high ozone concentrations, while revealing regional differences (e.g. West Coast ozone episodes feature anomalously high temperatures, while Southeast ozone episodes do not). In all regions, the composite patterns feature an anticyclonic circulation anomaly aloft, embedded in large-scale wave patterns that persist on timescales longer than typical air quality forecasts. These large-scale circulation patterns could potentially be useful for air quality prediction and estimation of ozone pollution episode frequency in climate change scenarios.