Many streams and rivers throughout North America have been extensively straightened, widened, and hardened since the middle 1800s, but related effects on aquatic ecosystems have seldom been monitored, described, or published. Beginning in the early 1990s, reach-level restoration efforts began to base projects on natural channel design (NCD) techniques and Rosgen's (1994b, 1996) river classification system in an effort to duplicate or mimic stable reference reach geomorphology. Four reaches in three streams of the Catskill Mountains, New York, were restored from 2000 to 2002 using NCD techniques to decrease bed and bank erosion rates, decrease sediment loads, and improve water quality. The effects of restoration on the health of fish assemblages were assessed through a before-after, control-impact (BACI) study design to quantify the net changes in population and community indices at treatment reaches relative to index changes at unaltered reference reaches from 1999 to 2004. After restoration, community richness and biomass at treatment reaches increased by more than one-third. Changes in fish communities were caused mainly by shifts in dominant species populations; fish community biomass and total fish abundance were generally dominated by daces or daces and sculpins before restoration and by one or more salmonid species after restoration. Density and biomass of eastern blacknose dace Rhinichthys atratulus, longnose dace R. cataractae, and slimy sculpin Cottus cognatus did not change appreciably, whereas net salmonid density and biomass increased substantially after restoration. These changes were driven primarily by large increases in populations of brown trout Salmo trutta. The findings demonstrate that the structure, function, and ultimately the health of resident fish populations and communities can be improved, at least over the short term, through NCD restoration in perturbed streams of the Catskill Mountains. ?? Copyright by the American Fisheries Society 2008.