River restoration is an increasingly common approach utilized to reverse past degradation of freshwater ecosystems and to mitigate the anticipated damage to freshwaters from future development and resource-extraction activities. While the practice of river restoration has grown exponentially over the last several decades, there has been little empirical evaluation of whether restoration projects individually or cumulatively achieve the legally mandated goals of improving the structure and function of streams and rivers. New efforts to evaluate river restoration projects that use channel reconfiguration as a methodology for improving stream ecosystem structure and function are finding little evidence for measurable ecological improvement. While designed channels may have less-incised banks and greater sinuousity than the degraded streams they replace, these reach-scale efforts do not appear to be effectively mitigating the physical, hydrological, or chemical alterations that are responsible for the loss of sensitive taxa and the declines in water quality that typically motivate restoration efforts. Here we briefly summarize this new literature, including the collection of papers within this Invited Feature, and provide our perspective on the limitations of current restoration.