Individual size distributions (ISDs) are prominent in ecological research and may support resource managers with ecosystem-scale objectives. We use a database of individual size measurements for US stream fishes to test for direct and indirect effects of traits, flow regimes, and land use on the interspecific ISD exponent. Path analysis indicates that traits have strong, direct effects on ISD. Flow and land use effects on the exponent are largely indirectly mediated by their influences on species traits. ISD exponents increase (abundances of larger-bodied individuals increase, relative to smaller-bodied) when environments favor higher trophic levels, warmer thermal tolerances, and periodic life histories. Alternatively, ISD exponents decrease in systems that favor opportunistic life histories. Our flexible modeling framework that includes direct and indirect effects of traits, flow regimes, and land use on ISD could be expanded to incorporate additional variables that interact with flow (e.g., temperature and physical habitat) to assess of effects of multiple stressors on aquatic ecosystem functioning.