The hydrology and geomorphology of large rivers in America reflect the pervasive influence of an extensive water control infrastructure including more than 75,000 dams. One hundred thirty-seven of the very large dams, each storing 1.2 km 3 (10 6 acre feet) of water or more, alter the flows of every large river in the country. The hydrologic effects of these very large dams emerge from an analysis of the stream gage records of 72 river reaches organized into 36 pairs. One member of each pair is an unregulated reach above a dam, whereas the other is a regulated reach downstream from the same structure. Comparison of the regulated and unregulated reaches shows that very large dams, on average, reduce annual peak discharges 67% (in some individual cases up to 90%), decrease the ratio of annual maximum/mean flow 60%, decrease the range of daily discharges 64%, increase the number of reversals in discharge by 34%, and reduce the daily rates of ramping as much as 60%. Dams alter the timing of high and low flows and change the timing of the yearly maximum and minimum flows, in some cases by as much as half a year. Regional variation in rivers, dams, and responses are substantial: rivers in the Great Plains and Ozark/Ouachita regions have annual maximum/mean flow ratios that are 7 times greater than ratios for rivers in the Pacific Northwest. At the same time, the ratio of storage capacity/mean annual water yield for dams is greatest for Interior Western, Ozark/Ouachita and Great Plains rivers and least for Pacific Northwest streams. Thus, in many cases those rivers with the highest annual variability have the greatest potential impact from dams because structures can exert substantial control over downstream hydrology. The hydrologic changes by dams have fostered dramatic geomorphic differences between regulated and unregulated reaches. When compared to similar unregulated reaches, regulated reaches have 32% larger low flow channels, 50% smaller high flow channels, 79% less active flood plain area, and 3.6 times more inactive flood plain area. Dams also affect the area of active areas, the functional surfaces that are functionally connected to the present regime of the river. Regulated reaches have active areas that are 72 smaller than the active areas of similar unregulated reaches. The geomorphic complexity (number of separate functional surfaces per unit of channel length) is 37% less in regulated reaches. Reductions in the size of hydrologically active functional surfaces are greatest in rivers in the Great Plains and least in Eastern streams. The largest differences in geomorphic complexity are in interior western rivers. The shrunken, simplified geomorphology of regulated large rivers has had direct effects on riparian ecology, producing spatially smaller, less diverse riparian ecosystems compared to the larger, more complex ecosystems along unregulated reaches of rivers.