The phrase "stream restoration" has become commonplace to describe a wide variety of stream intervention practices. Rather than using the term "restoration" to cover the broad range of stream interventions, many of which are not restoration at all, the Center for Watershed Protection has moved to using the phrase "stream repair". In this paper, a risk-based framework is presented for planning and designing stream repair projects, particularly in the vicinity of infrastructure. The method incorporates a wide variety of uncertainties, including non-quantifiable types, such as aesthetics, failure consequences, etc., providing a systematic approach to reducing risk prior to implementation. Individual components of a stream repair project, as well as the overall design, are considered. The results provide a basis for decision-making in determining the best option for stream repair and provides a powerful tool for communication between practitioners engaged in design, environmental funding and permitting agencies, infrastructure owners, and other stream stake-holders.