Southern Appalachian forests are recognized as a biodiversity hot spot of global significance, particularly for endemic aquatic salamanders and mussels. The dominant driver of land-cover and land-use change in this region is surface mining, with an ever-increasing proportion occurring as mountaintop mining with valley fill operations (MTVF). In MTVF, seams of coal are exposed using explosives, and the resulting noncoal overburden is pushed into adjacent valleys to facilitate coal extraction. To date, MTVF throughout the Appalachians have converted 1.1 million hectares of forest to surface mines and buried more than 2,000 km of stream channel beneath mining overburden. The impacts of these lost forests and buried streams are propagated throughout the river networks of the region as the resulting sediment and chemical pollutants are transmitted downstream. There is, to date, no evidence to suggest that the extensive chemical and hydrologic alterations of streams by MTVF can be offset or reversed by currently required reclamation and mitigation practices.