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Mid-latitude alpine caves preserve a record of past solid precipitation during winter, locally spanning several centuries to millennia. Dating organic macro-remains trapped in ice layers allows the determination of timing and duration of past periods of positive and negative ice mass balance. We present here the largest comparative study of ice cave sites yet published, using Bayesian age-modelling on a database comprising 107 radiocarbon dates, spread over eight caves in the Austrian Alps. We show that periods of positive mass balance coincide with past glacier advances. We find organic and macro-remain rich layers dated to the Medieval Climate Anomaly (between 850 and 1200 CE) marking widespread ice retreat. We demonstrate positive ice mass balance at all studied sites for the Little Ice Age, coinciding with the largest glacier advances in the Holocene between 1400 and 1850 CE. At the sites with records spanning over 2000 years, positive mass balance is also observed during the periods from 300 BCE to 100 CE and 600–800 CE. These subterranean ice deposits show widespread evidence of accelerated negative mass balances in recent years and their record is under imminent threat of disappearing. [ABSTRACT FROM AUTHOR]