Floodplain systems in the Driftless Area have experienced widespread historical transformations in hydrologic and sediment characteristics as well as rates of hydrogeomorphic processes. These changes exceed natural variability experienced during the Holocene and are driven by nearly two centuries of major land-cover alterations coupled with shifting precipitation patterns. On the pre–Euro-American landscape, tributaries to the Upper Mississippi River had clear, constant base flow and low sedimentation rates due to a protective cover of prairie, oak savanna, and woodland. The Upper Mississippi River was sandy and braided, with geomorphologically diverse backwaters, side channels, and vegetated islands. Soil erosion and gullying caused by agriculture-related land clearance have had the largest historical effects on Upper Mississippi River tributary stream morphology and floodplain sedimentation. Floodplain sedimentation rates for tributaries and the Upper Mississippi River were 0.2 and 0.9 mm/yr, respectively, before Euro-American settlement, compared to 2–20 and 5–20 mm/yr after Euro-American settlement, respectively. The soil conservation movement had its birthplace in the Driftless Area in the 1920s because of the region’s widespread landscape degradation. As soil erosion decreased and gullies were stabilized in the middle to late twentieth century, land management efforts turned toward the lingering problem of fine-grained, phosphorus-rich sediment stored in tributary floodplains and channels. This trend has been complicated by a climatic shift in the late twentieth century toward increased annual precipitation, increased flood variability, and more floods in late fall and winter months, when bare fields are vulnerable to runoff. Floods are major contributors to channel erosion and deposition, and variability in magnitudes and frequency will likely continue in the early twenty-first century. Restoration efforts in tributaries have included reducing bank erosion, reconnecting floodplains, and adding trout habitat features. Lock and dam structures have altered sediment transport and erosion processes within the Upper Mississippi River, and restoration efforts there have focused on creation and rehabilitation of islands and protection of remnant off-channel backwater habitats.