The development of water resources to satisfy urban water needs has had serious impacts on freshwater ecosystem integrity and on valuable ecosystem services, but positive trends are emerging that point the way toward a solution.We demonstrate this through case studies of water resource development in and around five large urban areas: Los Angeles, Phoenix, New York, San Antonio, and Atlanta. Providing freshwater ecosystems with the water flows necessary to sustain their health, while meeting the other challenges of urban water management, will require greatly increased water productivity in conjunction with improvements in the degree to which planning and management take ecosystem needs into account. There is great potential for improvement in both these areas, but ultimately water planners will also need to set limits on human alterations to river flows in many basins in order to spur greater water productivity and protect ecosystem water allocations before water supplies become overtaxed.