Urban areas are increasing in size and human population density. The implications of widespread urbanization are apparent for a wide variety of stream organisms, but the responses of stream-dwelling salamanders to urbanization have been understudied historically. Studies on this assemblage have increased sufficiently over the last decade to warrant a review and synthesis of current knowledge. Our survey of the literature indicates a research bias toward species within the Piedmont ecoregion of the USA and a strong emphasis on changes in species richness, relative abundance, and occupancy along an urbanization gradient. Very few investigators have examined vital rates for specific life stages, population dynamics over extended periods, or mechanistic explanations for the specific aspects of urbanization that drive species loss and decline. We reviewed a broad array of literature on stream salamanders to identify the key abiotic and biotic drivers that explain species responses in urban watersheds. Based on these findings and the applied ecological literature, we identified conservation options for urban areas where decision makers and stakeholders wish to preserve stream salamanders and their habitats. We have listed 7 future research priorities that will further efforts to conserve stream salamanders in rapidly urbanizing regions.