Despite expenditures of more than 1 billion dollars annually, there is little information available about project motivations, actions, and results for the vast majority of river restoration efforts. We performed confidential telephone interviews with 317 restoration project managers from across the United States with the goals of (1) assessing project motivations and the metrics of project evaluation and (2) estimating the proportion of projects that set and meet criteria for ecologically successful river restoration projects. According to project managers, ecological degradation typically motivated restoration projects, but post-project appearance and positive public opinion were the most commonly used metrics of success. Less than half of all projects set measurable objectives for their projects, but nearly two-thirds of all interviewees felt that their projects had been “completely successful.” Projects that we classified as highly effective were distinct from the full database in that most had significant community involvement and an advisory committee. Interviews revealed that many restoration practitioners are frustrated by the lack of funding for and emphasis on project monitoring. To remedy this, we recommend a national program of strategic monitoring focused on a subset of future projects. Our interviews also suggest that merely conducting and publishing more scientific studies will not lead to significant improvements in restoration practice; direct, collaborative involvement between scientists, managers, and practitioners is required for forward progress in the science and application of river restoration.