Sustaining natural levels of base flow is critical to maintaining ecological function as stream catchments are urbanized. Stream base flow responds variably to urbanization. Base flow or water tables rise in some locations, fall in others, or remain constant. This variable response is the result of the array of natural (e.g., physiographic setting and climate) and anthropogenic (e.g., urban development and infrastructure) factors that influence hydrology. Perhaps because of this complexity, few simple tools exist to assist managers to predict baseflow change in their local urban area. We address this management need by presenting a decision-support tool that can be used to predict the likelihood and direction of baseflow change based on the natural vulnerability of the landscape and aspects of urban development. When the tool indicates a likely increase or decrease, managers can use it for guidance toward strategies that can reduce or increase groundwater recharge, respectively. An equivocal result from application of the tool suggests the need for a detailed water balance. The tool is embedded in an adaptive-management framework that encourages managers to define their ecological objectives, assess the vulnerability of their ecological objectives to changes in water-table height, and monitor baseflow responses to urbanization. We tested our framework with 2 different case studies: Perth, Western Australia, Australia and Baltimore, Maryland, USA. Together, these studies show how predevelopment water-table height, climate, and geology together with aspects of urban infrastructure (e.g., stormwater practices, leaky pipes) interacted such that urbanization led to rising (Perth) and falling (Baltimore) base flow. Greater consideration of subsurface components of the water cycle will help to protect and restore the ecology of urban fresh waters.