Undoing harm caused by catchment urbanization on stream channels and their resident biota is challenging because of the range of stressors in this environment. One primary way in which urbanization degrades biological conditions is by changing flow patterns; thus, reestablishing natural flow regimes in urban streams demands particular attention if restoration is to have a chance for success. Enhancement efforts in urban streams typically are limited to rehabilitating channel morphology and riparian habitat, but such physical improvements alone do not address all factors affecting biotic health. Some habitat-forming processes such as the delivery of woody debris or sediment may be amenable to partial restoration, even in highly disturbed streams, and they constitute obvious high-priority actions. There is no evidence to suggest, however, that improving nonhydrologic factors can fully mitigate hydrologic consequences of urban development. In the absence of effective hydrologic mitigation, appropriate short-term rehabilitation objectives for urban channels should be to 1) eliminate point sources of pollution, 2) reconstruct physical channel elements to resemble equivalent undisturbed channels, and 3) provide habitat for self-sustaining biotic communities, even if those communities depart significantly from predisturbance conditions. Long-term improvement of stream conditions is not feasible under typical urban constraints, so large sums of money should not be spent on unrealistic or unreachable targets for stream rehabilitation. However, such a strategy should not be an excuse to preclude potential future gains by taking irreversible present-day development or rehabilitative actions.