The Opuha Dam was designed for water storage, hydropower, and to augment summer low flows. Following its commissioning in 1999, algal blooms (dominated first by Phormidium and later Didymosphenia geminata) downstream of the dam were attributed to the reduced frequency and magnitude of high-flow events. In this study, we used a 20-year monitoring dataset to quantify changes associated with the dam. We also studied the effectiveness of flushing flows to remove periphyton from the river bed. Following the completion of the dam, daily maximum flows downstream have exceeded 100 m(3) s(-1) only three times; two of these floods exceeded the pre-dam mean annual flood of 203 m(3) s(-1) (compared to 19 times >100 m(3) s(-1) and 6 times >203 m(3) s(-1) in the 8 years of record before the dam). Other changes downstream included increases in water temperature, bed armoring, frequency of algal blooms, and changes to the aquatic invertebrate community. Seven experimental flushing flows resulted in limited periphyton reductions. Flood wave attenuation, bed armoring, and a shortage of surface sand and gravel, likely limited the effectiveness of these moderate floods. Floods similar to pre-dam levels may be effective for control of periphyton downstream; however, flushing flows of that magnitude are not possible with the existing dam infrastructure. These results highlight the need for dams to be planned and built with the capacity to provide the natural range of flows for adaptive management, particularly high flows.