Results/Conclusions: We found that Spokane river study reaches vary in characteristics indicative of ecosystem health and this is reflected in the communities of macroinvertebrates found in each reach. Mean water temperatures clearly demarcate aquifer influence; upstream and downstream gaining reaches were 14.9 C and 14.8 C, respectively. Mean water temperatures for upstream losing reaches were 27.7 C. The most distinct macroinvertebrate differences were also found between ”gaining” reaches and “losing” reaches. All gaining reaches were characterized by an abundance of species representative of high water quality such as Antocha craneflies, Pteronarcys stoneflies and Calineuria stoneflies. Warmer “losing” reaches had higher densities of multivolting dipterans, such as Simuliidae and Chironomidae. The unique Spokane river macroinvertebrate community is dominated in all three reaches by heavy metal tolerant species. Metal tolerant Hydropsyche caddisflies, and Baetid mayflies were among the most abundant invertebrates in all study reaches, while metal intolerant Heptageniid mayflies were absent (though commonly found in local streams with otherwise similar fauna), suggesting that metal pollution from the Coeur d’ Alene Basin upstream is influencing Spokane River communities. The results of our study demonstrate that macroinvertebrates can be a useful indicator of ecosystem health in the Spokane River and we recommend an annual monitoring program to document changes in anthropogenic impacts. The direct correlation between stream health and the observable macroinvertebrate communities can be easily comprehended by the community and used to generate interest and encourage stewardship.