This paper presents an extensive study of the interplay between as-fabricated (time-zero) variability and gate oxide reliability (time-dependent variability) in contemporary pMOSFETs. We compare physical simulation results using the atomistic simulator GARAND with experimental measurements. The TCAD simulations are accurately calibrated to reproduce the average transistor behavior. When random discrete dopants, line edge roughness, and gate polysilicon granularity are considered, the simulations accurately reproduce time-zero (as-fabricated) statistical variability, as well as time-dependent variability data, represented by threshold voltage shift distributions. The calibrated simulations are then used to predict the reliability behavior at different bias conditions and for different device dimensions.Index Terms-Atomistic doping, random telegraph noise (RTN), reliability, statistical simulations.