Consistent assessments of biological condition are needed across multiple ecoregions to provide a greater understanding of the spatial extent of environmental degradation.  Although the index of biotic integrity (IBI) has been widely used in eastern North America, IBI development has been hindered in the western U.S. because of relatively low fish species richness and greater relative abundance of alien fishes.  We evaluated IBIs recently proposed for three large-scale ecoregions of the western U.S. (collectively referred to as West-wide) to assess their responsiveness to basin-level anthropogenic disturbance (urban and agricultural land uses).  We also assessed their precision and their concordance with previously developed basin-scale IBIs. Anthropogenic disturbance was significantly related (P = 0.001; rho = -0.40) to IBI scores from 318 sites in the western U.S. ranging across mountains, plains, and xeric ecoregions.  Standard deviations and coefficients of variation revealed relatively low variation of IBI scores based on multiple sampling reaches at sites.  A relatively high degree of corroboration with independent, locally developed IBIs indicates that the West-wide IBIs are robust across large geographic scales.  Our results indicate that West-wide IBIs can provide precise and accurate assessments of biological condition for western U.S. streams.