The Spanish Fork River in Utah County, Utah, is a stream affected by high suspended sediment loads originating from a large part of its basin.  In the fall of 2003, a 1-km reach of the river was rehabilitated with heavy equipment to reconstruct meanders, stabilize banks, and increase amounts of in-stream structure.  Before construction, the reach was characterized extensive sedimentation that caused extreme compaction of sediments.  Studies of the macroinvertebrate community that began in 2002 showed that it was relatively poor in quality with low densities of sediment-tolerant taxa. Construction activities improved substrates by increasing amounts of cobble and reducing compaction.  By fall 2004, total taxa had increased by 50% and total density had increased six-fold.  Taxa intolerant of sedimentation, including Baetis, simulids, Hydropsyche, and elmid beetles, increased in number, whereas tolerant taxa, such as isopods, decreased.  However, continued high sediment input from upstream tributaries has resulted in reduced cobble and increased substrate compaction since 2005.  Consequently, macroinvertebrate diversity and abundance has declined to pre-restoration levels. This example illustrates the difficulty of restoring isolated stream reaches when the causative problem is basin-wide.