Natural-channel-design (NCD) restorations were recently implemented within large segments of five first- and second-order streams in the Catskill Mountains of New York in an attempt to increase channel stability, reduce bed and bank erosion, and sustain water quality. In conjunction with these efforts, 54 fish and habitat surveys were done from 1999 to 2007 at six restored reaches and five stable control reaches to evaluate the effects of NCD restoration on fish assemblages, habitat, and bank stability. A before–after–control–impact study design and two-factor analysis of variance were used to quantify the net changes in habitat and fish population and community indices at treatment reaches relative to those at unaltered control reaches. The density and biomass of fish communities were often dominated by one or two small prey species and no or few predator species before restoration and by one or more trout (Salmonidae) species after restoration. Significant increases in community richness (30%), diversity (40%), species or biomass equitability (32%), and total biomass (up to 52%) in at least four of the six restored reaches demonstrate that NCD restorations can improve the health and sustainability of fish communities in geomorphically unstable Catskill Mountain streams over the short to marginally long term. Bank stability, stream habitat, and trout habitat suitability indices (HSIs) generally improved significantly at the restored reaches, but key habitat features and trout HSIs did not change or decreased at two of them. Fish communities and trout populations at these two reaches were not positively affected by NCD restorations. Though NCD restorations often had a positive effect on habitat and fish communities, our results show that the initial habitat conditions limit the relative improvements than can be achieved, habitat quality and stability do not necessarily respond in unison, and biotic and abiotic responses cannot always be generalized.