Stream restoration practice typically relies on a geomorphological design approach in which the integration of ecological criteria is limited and generally qualitative, although the most commonly stated project objective is to restore biological integrity by enhancing habitat and water quality. Restoration has achieved mixed results in terms of ecological successes and it is evident that improved methodologies for assessment and design are needed. A design approach is suggested for mesohabitat restoration based on a review and integration of fundamental processes associated with: (1) lotic ecological concepts; (2) applied geomorphic processes for mesohabitat self-maintenance; (3) multidimensional hydraulics and habitat suitability modeling; (4) species functional traits correlated with fish mesohabitat use; and (5) multi-stage ecohydraulics-based mesohabitat classification. Classification of mesohabitat units demonstrated in this article were based on fish preferences specifically linked to functional trait strategies (i.e., feeding resting, evasion, spawning, and flow refugia), recognizing that habitat preferences shift by season and flow stage. A multi-stage classification scheme developed under this premise provides the basic "building blocks" for ecological design criteria for stream restoration. The scheme was developed for Midwest US prairie streams, but the conceptual framework for mesohabitat classification and functional traits analysis can be applied to other ecoregions.