Stream flow augmentation with recycled water has the potential to improve stream habitat and increase potable water supply, but the practice is not yet well understood or documented. The objectives of this report are to present a short review illustrated by a case study, followed by recommendations for future stream flow augmentation projects. Despite the fact that wastewater discharge to streams is commonplace, a water agency pursuing stream flow augmentation with recycled water will face unique challenges. For example, recycled water typically contains trace amounts of organic wastewater-derived compounds (OWCs) for which the potential ecological risks must be balanced against the benefits of an augmentation project. Successful stream flow augmentation with recycled water requires that the lead agency clearly articulate a strong project rationale and identify key benefits. It must be assumed that the public will have some concerns about water quality. Public acceptance may be better if an augmentation project has co-benefits beyond maintaining stream ecosystems, such as improving water system supply and reliability (i.e. potable use offset). Regulatory or project-specific criteria (acceptable concentrations of priority OWCs) would enable assessment of ecosystem impacts and demonstration of practitioner compliance. Additional treatment (natural or engineered) of the recycled water may be considered. If it is not deemed necessary or feasible, existing recycled water quality may be adequate to achieve project goals depending on project rationale, site and water quality evaluation, and public acceptance.