Climate change influences on mountain hydrology are uncertain, but likely to be mediated through changes in subsurface hydrologic residence times and flowpaths. The heterogeneity of karst aquifers add complexity in assessing the resiliency of these water sources to perturbation, suggesting a clear need to quantify contributions from and losses to these aquifers. Here we develop a stream centric method that combines mass and flow balances to quantify net and gross gains and losses at different spatial scales. We then extend these methods to differentiate between karst conduit and matrix contributions from the aquifer. In the Logan River watershed in Northern Utah we found significant amounts of the river water repeatedly gained and then lost through a 35 km study reach. Further, the direction and amount of water exchanged varied over space, time, and discharge. Streamflow was dominated by discharge of karst conduit groundwater after runoff with increasing, yet still small, fractions of matrix water later in the summer. These findings were combined with geologic information, prior subsurface dye tracing, and chemical sampling to provide additional lines of evidence that repeated groundwater exchanges are likely occurring and river flows are highly dependent on karst aquifer recharge and discharge. Given the large population dependent on karst aquifers throughout the world, there is a continued need to develop simple methods, like those presented here, for determining the resiliency of karst groundwater resources.