Macroinvertebrate assemblages often remain depauperate in physically restored urban streams despite efforts to improve habitat conditions and increase species abundance and diversity. The lack of biological recovery may be due to a lack of a natural, nearby source of colonists, and this has inspired researchers and practitioners to reintroduce macroinvertebrates in otherwise restored urban streams to jump start the recovery process. However, without standardized guidelines that describe reintroduction best practices, some reintroduction programs may create additional problems (e.g., disease spread, genetic homogenization, population loss). To reduce these risks and limit a potential waste of resources, a cautionary approach is warranted. In this paper we summarize current stream reintroduction knowledge and detail best practices for aquatic macroinvertebrate reintroduction in restored urban streams. We provide criteria that managers can use to determine whether reintroduction is appropriate and demonstrate how researchers can use reintroduction as a tool to test hypotheses regarding factors limiting recolonization. We provide guidance for how to set clear reintroduction goals, select donor sites, determine the number of organisms required, establish reintroduction frequency and timing, and overcome challenges associated with monitoring. This framework can help managers create more successful reintroduction programs that can benefit urban stream restoration.