On 12-13 November 2003, the Great Lakes region was heavily impacted by an intense extratropical cyclone associated with an upper-level tropopause fold. The post-cold frontal, non-convective winds battered areas from Iowa to Pennsylvania, resulting in eight deaths, 23 injuries, and over $36 million USD in damages. The transport of high-momentum air produced surface winds reaching 39 ms-1, which were also responsible for producing a major seiche event on Lake Erie. This paper analyzes the synoptic conditions and their correlations with Lake Erie water levels at various locations along the coast: Toledo, Ohio; Buffalo, New York; and Cleveland, Ohio respectively. The lake orientation is also taken into account when compared to the climatology of NCWEs in the Great Lakes region.