Rapid urbanization has resulted in a series of sequential effects on a desert stream in the American Southwest. Lower Las Vegas Wash was a dry wash characterized by infrequent flood deposition when Las Vegas, Nevada was established in 1905. Wastewater effluent was discharged into the wash in low volumes for over 3 decades. Wastewater volumes increased commensurably with accelerated population growth during the late 20th century and created a sequence of feedback effects on the floodplain. Initially slow saturation of the valley fill created a desert oasis of dense floodplain vegetation and wetlands. Annual streamflow began in 1958 and erosion began a decade later with shallow incision in discontinuous channel segments. Increasing baseflow gradually enlarged channels; headcutting was active during the 1970s to 1984. The incised channels concentrated storm runoff, which accelerated local channel erosion, and in 1984 the headcuts were integrated during a series of monsoon floods. Wetlands were drained and most floodplain vegetation destroyed. Channel erosion continued unabated until engineering interventions began in the 21st century. No natural channel recovery occurred after initial urbanization effects because streamflow never stabilized in the late 20th century. A 6.6 M m³ sediment slug, eroded from the wash in ∼25 years, was deposited in Las Vegas Bay in Lake Mead. Falling reservoir levels during the 21st century are responsible for sediment redistribution and infilling of the bay. Close monitoring of impacts is recommended when urban wastewater and storm runoff are discharged on a desert wash. Channel interventions, when necessary, are advised in order to prevent costly engineering schemes of channel stabilization, flood control, and floodplain restoration.