The amphipod genus Gammarus is widespread and is structurally and functionally important in epigean freshwaters of the Northern Hemisphere. Its presence is crucial, because macroinvertebrate feeding is a major rate-limiting step in the processing of stream detrius. In addition, Gammarus interacts with multiple trophic levels bu functioning as prey, predator, herbivore, detritivore, and shredder. Such a broad span of ecosystem participation underlines the importance of Gammarus to pollutants and other disturbances may render it a valuable indicator for ecosystem health. This review summarizes the vast number of studies conducted with Gammarus spp. for evaluating aquatic ecotoxicology endpoints and examines the suitability of this native invertabrate species for the assessment of stream ecosystem health in the Northern Hemisphere. Numerous papers have been published on how pollutants affect gammarind behavior (i.e., mating, predator avoidance), reproduction, development, feeding activity, population structure, as well as the consequences of pollution on host-parasite, predator-prey, or native-invasive species interactions. Some biochemical and molecular biomarkers have already been established, such as the measurement of vitellogenin-like proteins, metallothioneins, alkali-labile phosphates (in proteins), and lipogenic enzyme activities for assessing endocrine distribution and detoxification mechanisms.