Despite some highly visible projects that have resulted in environmental benefits, recent efforts to quantify the number and distribution of river restoration projects revealed a paucity of written records documenting restoration outcomes. Improving restoration designs and setting watershed priorities rely on collecting and making accessible this critical information. Information within the unpublished notes of restoration project managers is useful but rarely documents ecological improvements. This special section of Restoration Ecology is devoted to the current state of knowledge on river restoration. We provide an overview of the section’s articles, reflecting on lessons learned, which have implications for the implementation, legal, and financing frameworks for restoration. Our reflections are informed by two databases developed under the auspices of the National River Restoration Science Synthesis project and by extensive interactions with those who fund, implement, and permit restoration. Requiring measurable ecological success criteria, comprehensive watershed plans, and tracking of when and where restoration projects are implemented are critical to improving the health of U.S. waters. Documenting that a project was put in the ground and stayed intact cannot be equated with ecological improvements. However, because significant ecological improvements can come with well-designed and -implemented stream and river restorations, a small investment in documenting the factors contributing to success will lead to very large returns in the health of our nation’s waterways. Even projects that may appear to be failures initially can be turned into success stories by applying the knowledge gained from monitoring the project in an adaptive restoration approach.