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River damming has dramatic environmental impacts and while changes due to reservoir flooding are immediate, downstream impacts are more spatially extensive. Downstream environments are influenced by the pattern of flow regulation, which also provides an opportunity for mitigation. We discuss impacts downstream from dams and recent case studies where collaborative efforts with dam operators have led to the recovery of more natural flow regimes. These restoration programs, in Nevada, USA, and Alberta, Canada, focused on the recovery of flow patterns during high flow years, because these are critical for riparian vegetation and sufficient water is available for both economic commitments and environmental needs. The restoration flows were developed using the “Recruitment Box Model”, which recommends high spring flows and then gradual flow decline for seedling survival. These flow regimes enabled extensive recruitment of cottonwoods and willows along previously impoverished reaches, and resulted in improvements to river and floodplain environments. Such restoration successes demonstrate how instream flow management can act as a broadly applicable tool for the restoration of floodplain forests.