Strategies for river restoration or enhancement have evolved rapidly during the past three decades and are usually undertaken to correct adverse impacts resulting from damaging management activities. Examples from the Western States will illustrate early approaches which concentrated on piece-meal restoration of local habitat, frequently undertaken without due regard to hydraulics, geomorphology, sediment transport characteristics or regional ecological linkages. More recent strategies have shown that adverse impacts to the aquatic ecosystem induced by watershed scale changes often require remedial management actions at the watershed scale to address the issues in a sustainable manner. It has also been recognized that the key to many enhancement projects depends upon our ability to restore the physical processes that create and maintain a healthy river system. Development of a sustainable solution often requires a long-term strategy, since some actions may take years to implement and this may be followed by another extensive interval before downstream benefits are achieved. Peer review groups (for example, the Independent Scientific Review Panel within the Columbia Basin) have raised poignant questions about how limited mitigation funds should be invested. In particular, how should potential enhancement activities be prioritized for the greatest benefit of the ecological resources? Secondly, can the ecological benefits of local restoration or enhancement projects be quantitatively proven at the local and watershed scale? A methodology for a decision framework for the selection of sites, examples of specific river restoration strategies, establishment of performance criteria for quantifying the performance at the local and watershed scales is outlined.