Consistent assessments of biological condition are needed across multiple ecoregions to provide a greater understanding of the spatial extent of environmental degradation. However, consistent assessments at large geographic scales are often hampered by lack of uniformity in data collection, analyses, and interpretation. The index of biotic integrity (IBI) has been widely used in eastern and central North America, where fish assemblages are complex and largely composed of native species, but IBI development has been hindered in the western United States because of relatively low fish species richness and greater relative abundance of alien fishes. Approaches to developing IBIs rarely provide a consistent means of assessing biological condition across multiple ecoregions. We conducted an evaluation of IBIs recently proposed for three ecoregions of the western United States using an independent data set covering a large geographic scale. We standardized the regional IBIs and developed biological condition criteria, assessed the responsiveness of IBIs to basin-level land uses, and assessed their precision and concordance with basin-scale IBIs. Standardized IBI scores from 318 sites in the western United States comprising mountain, plains, and xeric ecoregions were significantly related to combined urban and agricultural land uses. Standard deviations and coefficients of variation revealed relatively low variation in IBI scores based on multiple sampling reaches at sites. A relatively high degree of corroboration with independent, locally developed IBIs indicates that the regional IBIs are robust across large geographic scales, providing precise and accurate assessments of biological condition for western U.S. streams. ?? Copyright by the American Fisheries Society 2008.