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The authors of this Policy Forum developed a comprehensive database of >37,000 river restoration projects across the United States. Such projects have increased exponentially over the past decade with more than a billion dollars spent annually since 1990. Most are intended to enhance water quality, manage riparian zones, improve in-stream habitat, allow fish passage, and stabilize stream banks. Only 10% of project records document any form of project monitoring, and little if any of this information is either appropriate or available for assessing the ecological effectiveness of restoration activities.