Natural stream channel design principles and riparian restoration practices were applied during spring 2010 to an agriculturally impaired reach of the Cacapon River, a tributary of the Potomac River which flows into the Chesapeake Bay. Aquatic macroinvertebrates and fishes were sampled from the restoration reach, two degraded control, and two natural reference reaches prior to, concurrently with, and following restoration (2009 through 2010). Collector filterers and scrapers replaced collector gatherers as the dominant macroinvertebrate functional feeding groups in the restoration reach. Before restoration, based on indices of biotic integrity (IBI), the restoration reach fish and macroinvertebrate communities closely resembled those sampled from the control reaches, and after restoration more closely resembled those from the reference reaches. Although the macroinvertebrate community responded more favorably than the fish community, both communities recovered quickly from the temporary impairment caused by the disturbance of restoration procedures and suggest rapid improvement in local ecological conditions.