Rapid population growth and land use changes have severely degraded streams across the United States. In response, there has been a surge in the number of stream restoration projects, including stream restoration for mitigation purposes. Currently, most projects do not include evaluation and monitoring, which are critical in the success of stream restoration projects. The goal of this study is to review the current status of assessment methodologies and restoration approaches for streams in Virginia, with the aim of assisting the restoration community in making sound decisions. As part of the study, stream restoration projects data from a project in Fairfax County, Virginia was assessed. This review revealed that the stream assessment methodologies currently applied to restoration are visuallybased and do not include biological data collection and/or a method to incorporate watershed information. It was found from the case study that out of the twenty nine restoration projects that had occurred between 1995 and 2003 in Fairfax County, nineteen projects reported bank stabilization as a goal or the only goal, indicating an emphasis on a single physical component rather than on the overall ecological integrity of streams. It also turned out that only seven projects conducted any level of monitoring as part of the restoration, confirming the lack of evaluation and monitoring. However, Fairfax County has recently improved its stream restoration practices by developing and incorporating watershed management plans. This now provides one of the better cases that might be looked upon by stakeholders when planning future stream restoration projects.