Alluvial plain landscapes are some of the most agriculturally productive lands in the world but often have modified stream ecosystems due to cultivation history. This context requires consideration when establishing water quality management goals. We analyzed state water quality databases to demonstrate that Mississippi Alluvial Plain (MAP) ecoregion streams have elevated specific conductivity (SC) and nutrients and lower macroinvertebrate local and regional taxa pools compared to streams in other ecoregions, potentially reducing the efficacy of traditional biomonitoring approaches within the region. To overcome these challenges, we used threshold indicator taxa analysis (TITAN) to compare macroinvertebrate assemblage responses to water quality gradients among ecoregions in Mississippi. We identified individual taxa and assemblage-level responses to increasing water quality degradation in MAP streams. Observed responses occurred at higher concentrations for SC, total organic carbon (TOC) and total phosphorus (TP), but not total nitrogen (TN) relative to other ecoregions. These responses appeared to be driven by a large proportion of indicator taxa considered tolerant or unresponsive in other ecoregions, responding negatively to increasing water quality stressors in MAP streams. Our observed assemblage-level stressor responses to WQ gradients in MAP streams demonstrate shifting tolerance in highly altered ecosystems may require adjustments to recovery expectations but also provide useful measures for monitoring improvements in regional water quality. For example, our observed macroinvertebrate assemblage response to increasing TP identified a management goal similar to guidance based on distributional analysis of water quality data within the MAP ecoregion (0.11 vs 0.128 mg L−1) and thus provide some biological basis for previously identified nutrient goals for the region. Our approach can guide and monitor success of nutrient reduction efforts in MAP watersheds and other alluvial plain agroecosystems where reference conditions do not exist, and local and regional taxa pools are less diverse and may not support full recovery of ecological assemblages. While our results are promising, they should also be compared with more sensitive and less habitat-limited biological assemblages (e.g., algae or bacteria) to better understand complex ecological responses to best management practices designed to increase sustainability of high production agricultural regions.