Extreme hourly rainfall accumulations (e.g., exceeding 75 mm h−1) in several noteworthy flash flood events have suggested that the most intense accumulations were attendant with discrete mesoscale rotation or rotation embedded within larger organized systems. This research aims to explore how often extreme short-term rain rates in the United States are associated with storm-scale or mesoscale vortices. Five years of METAR observations and three years of Stage-IV analyses were obtained and filtered for hourly accumulations over 75 and 100 mm, respectively, clustered into events, and subjectively identified for rotation. The distribution of the short-term, locally extreme events shows the majority of the events were located along the Atlantic and Gulf of Mexico coastlines with additional events occurring in the central plains and into the Midwest. Nearly 50% of the cases were associated with low-level rotation in high-precipitation supercells or mesoscale vortices embedded in organized storm modes. Rotation events occurred more clearly in the warm sector, while nonrotation events tended to occur along a surface boundary. The rotation events tended to produce higher hourly accumulations over a larger region, but were associated with somewhat stronger synoptic-to-mesoscale forcing for ascent and more total column moisture. These results support recent modeling results suggesting that rotationally induced dynamic vertical pressure perturbations should not be ignored when it comes to extreme precipitation and can potentially enhance the short-term rain rates.