Urban streams are affected by a complex combination of stressors, which modify physical habitat structure, flow regime, water quality, biological community composition, and ecosystem processes and services, thereby altering ecosystem structure and functioning. Rehabilitation projects have been undertaken in several countries to rehabilitate urban streams. However, stream rehabilitation is still rarely reported for neotropical regions. In addition, most studies focus on structural aspects, such as water quality, sediment control, and flood events, without considering ecosystem function indicators. Here, we evaluated the structure and functioning of three 15-y old rehabilitated urban stream sites in comparison with three stream sites in the best available ecological condition (reference), three sites with moderate habitat alteration, and three severely degraded sites. Compared to degraded streams, rehabilitated streams had higher habitat diversity, sensitive macroinvertebrate taxa richness, and biotic index scores, and lower biochemical oxygen demand, primary production, sediment deposition, and siltation. However, rehabilitated streams had higher primary production than moderate and reference streams, and lower canopy cover, habitat diversity, sensitive macroinvertebrate taxa richness, and biotic index scores than reference streams. These results indicate that rehabilitated streams have better structural and functional condition than degraded streams, but do not strongly differ from moderately altered streams, nor have they reached reference stream condition. Nonetheless, we conclude that rehabilitation is effective in removing streams from a degraded state by improving ecosystem structure and functioning. Furthermore, the combined use of functional and structural indicators facilitated an integrative assessment of stream ecological condition and distinguished stream conditions beyond those based on water quality indicators.