Catchment urbanization perturbs the water and sediment budgets of streams, degrades stream health and function, and causes a constellation of flow, water quality and ecological symptoms collectively known as the urban stream syndrome. Low-impact development (LID) technologies address the hydrologic symptoms of the urban stream syndrome by mimicking natural flow paths and restoring a natural water balance. Over annual time scales, the volumes of storm water that should be infiltrated and harvested can be estimated from a catchment-scale water-balance given local climate conditions and pre-urban land cover. For all but the wettest regions of the world, the water balance predicts a much larger volume of storm water runoff should be harvested than infiltrated to restore stream hydrology to a pre-urban state. Efforts to prevent or reverse hydrologic symptoms associated with the urban stream syndrome will therefore require: (1) selecting the right mix of LID technologies that provide regionally tailored ratios of storm water harvesting and infiltration; (2) integrating these LID technologies into next-generation drainage systems; (3) maximizing potential co-benefits including water supply augmentation, flood protection, improved water quality, and urban amenities; and (4) long-term hydrologic monitoring to evaluate the efficacy of LID interventions.