In the second half of the twentieth century, after the end of the Second World War, a considerable anthropogenic pressure was observed in most of the Mediterranean territories. This process has caused the expansion of existing settlements and the construction of numerous new towns, often located very close to rivers. A frequent consequence of this process is the transformation of several rivers through planform changes, narrowing, channelization and culverting to recover spaces where inhabited centers expanded, and the construction of structures interacting with rivers. This issue is very important in territories such as the Metropolitan City of Reggio Calabria, in southern Italy, which is an interesting case study due to the considerable anthropogenic pressures observed in the last 70 years. The main goal of this paper is to evaluate the effects of anthropogenic pressure in the last 70 years on some rivers of the Metropolitan City of Reggio Calabria in terms of the following issues: planform changes, channelization, culverting, and the presence of structures and infrastructures interacting with rivers. The specific goals of this paper are the quantification of the effects of anthropogenic pressure on the rivers of the study area analyzing sixteen parameters, the identification of possible conditions of hydraulic hazard through the analysis of past events, and the proposal of structural and non-structural mitigation interventions. In many rivers of the study area, the significant effects of anthropogenic pressure are visible through rivers that pass above highways, barred rivers, rivers replaced by roads and numerous crossing roads with a missing levee.