Hailstones are a natural hazard that pose a significant threat to property and are responsible for significant economic losses each year in the United States. Detailed understanding of their characteristics is essential to mitigate their impact. Identifying the dynamic and physical factors contributing to hail formation and hailstone sizes is of great importance to weather and climate prediction and policymakers. In this study, we have analyzed the temporal and spatial variabilities of severe hail occurrences over the U.S. southern Great Plains (SGP) states from 2004 to 2016 using two hail datasets: hail reports from the Storm Prediction Center and the newly developed radar-retrieved maximum expected size of hail (MESH). It is found that severe and significant severe hail occurrences have a considerable year-to-year temporal variability in the SGP region. The interannual variabilities have a strong correspondence with sea surface temperature anomalies over the northern Gulf of Mexico and there is no outlier. The year 2016 is identified as an outlier for the correlations with both El Niño–Southern Oscillation (ENSO) and aerosol loading. The correlations with ENSO and aerosol loading are not statistically robust to inclusion of the outlier 2016. Statistical analysis without the outlier 2016 shows that 1) aerosols that may be mainly from northern Mexico have the largest correlation with hail interannual variability among the three factors and 2) meteorological covariation does not significantly contribute to the high correlation. These analyses warrant further investigations of aerosol impacts on hail occurrence.