This article summarizes the studies concerning the impact of pollutants on benthic macroinvertebrate communities in the mountain and upland rivers of southern Poland. The Carpathian Raba River, which in the 1960s retained its natural character and had good water quality, was considered as a reference in terms of benthic macroinvertebrate communities. The other two analyzed rivers were polluted to different degrees. The Carpathian Dunajec River was contaminated mainly by sewage from small towns and treatment plant, while the upland Vistula River mainly by sewage from the Upper Silesian Industrial Region and saline waters from coal mines. In studied ecosystems in response to pollutions, a rapid increase in density of fauna caused mainly by the massive development of Oligochaeta was found. In the mountain river, the impact of contamination on macroinvertebrate diversity was negligible. There, taxa considered as indicators of clean water (Ephemeroptera, Plecoptera, and Trichoptera) were abundant and their diversity was similar to that of an uncontaminated river. In the heavily polluted upland Vistula River, the sites with a muddy bottom were dominated by Oligochaeta (99.4–99.9%), while at sites with stony bottoms, apart from Oligochaeta, there were also Chironomidae, Gastropoda, and Hirudinea. In comparison to the 1950s, all Ephemeroptera, Plecoptera, Odonata, Trichoptera, and Megaloptera were extinct.