Declines in many fish populations in large, western rivers have been primarily attributed to the anthropogenic reduction of nutrient inputs and subsequent impacts to the food web. The largest known river fertilization program was implemented starting in 2005 on the Kootenai River in northern Idaho to restore resident fisheries. Annual electrofishing surveys were conducted at multiple sites in Idaho and Montana before and during nutrient addition to evaluate assemblage and population-level responses. Although few responses in fish assemblage structure were observed, the addition of liquid ammonium polyphosphate fertilizer (3 μg/L) to the Kootenai River increased fish abundance and biomass over the 20-km stretch of river downstream of the treatment site. Increases were most notable in Largescale Suckers Catostomus macrocheilus, Mountain Whitefish Prosopium williamsoni, and Rainbow Trout Oncorhynchus mykiss populations, although increases in catch and biomass were detected for nearly all fish species. The Kootenai River is approximately 30 times larger in discharge than other rivers that have been experimentally fertilized and provides compelling evidence that the mitigation of nutrient declines in rivers of similar size can result in positive influences on the fish populations where primary and secondary production are limiting growth, survival, and recruitment. However, results from our study also highlight the importance of completing evaluations across varying levels of biological organization (e.g., assemblage and population) and over biologically relevant timeframes.