Stream flow is the primary abiotic factor influencing stream ecosystem function. Physical forces associated with the flow change habitat structure, translocate materials, and can influence organism dispersal ability and behavior. Benthic macroinvertebrates fulfill various functional roles within a stream that have a profound impact on nutrient cycling and primary productivity. As a result, much of the ecological integrity of a stream is interdependently linked to this interaction of flowing water and benthic organisms. However, natural systems have increasingly been under siege through flow alterations in the form of dams, land use, and storm events through global climate change. Stream macroinvertebrates may show morphological differences through a plastic response to changes in stream flow that could further alter an organism's ability to fulfill their functional role. Plasticity has been documented in fishes and the same may be observed for other stream biota. Our goal is to help elucidate an understanding of the direct and indirect pervasive effects associated with the natural flow regime on known sensitive and indicative benthic organisms. How organisms respond to flow alterations can provide useful taxon specific information for water resource management and enhance our interpretation of any evolutionary adaptations to flow that may be useful in the context of global climate change.