Complex hydroclimate in the United States and Canada has limited identification of possible ongoing changes in streamflow. We address this challenge by classifying 541 stations in the United States and Canada into 15 “hydro-regions,” each with similar seasonal streamflow characteristics. Analysis of seasonal streamflow records at these stations from 1910 to present indicates regionally coherent changes in the frequency of extreme high- and low-flow events. Where changes are significant, these events have, on average, doubled in frequency relative to 1950 to 1969. In hydro-regions influenced by snowmelt runoff, extreme high-flow event frequency has increased despite snowpack depletion by warming winter temperatures. In drought-prone hydro-regions of the western United States and Southeast, extreme low-flow event frequency has increased, particularly during summer and fall. The magnitude and regional consistency of these hydrologic changes warrant attention by watershed stakeholders. The hydro-region framework facilitates quantification and further analyses of these changes to extreme streamflow.