Over the past century, channelization, agricultural tiling, and land use changes have resulted in significant stream channel degradation of the Cache River in southern Illinois. With the increasing interest in restoration of the watershed's bottomland forests and swamps, we sought to characterize geomorphic change over the past 110 years to inform restoration and management. A previously surveyed stretch of river was resurveyed in the fall of 2011, following a record flood in the spring of that year. Results suggest that the slope of the channel in this section of the river has increased 345% between 1903 and 1972 ( p < 0.01), but has not changed significantly since ( p = 0.12). Within that same time period, bank heights increased between 1 and 7 m and bed elevation decreased between 1 and 5 m. Changes in resurveyed cross sections appear to be primarily due to recent flood scour. It appears as though early 20th Century stream channel modifications had immediate effects on the geomorphology of the channel; however, channel geometry is now at or near equilibrium. This case study of the Cache River watershed demonstrates how and why successful restoration will require integration of geomorphic processes of the system. [ABSTRACT FROM AUTHOR]