Urbanisation is acknowledged as one of the most severe threats to stream health, spawning recent research efforts into methods to ameliorate these negative impacts. Attention has focused on streams in densely-populated cities but less populous regional urban centres can be equally prone to some of the same threats yet might not meet the conventional definitions of urban. Several recent reviews have identified the changes to streams that occur during urbanization but they note that few ecological studies have explored eco-system-level responses, typically focusing instead on state variables such as invertebrate abundance. In many regional urban streams, changes to the extent of impervious drainage have implications for their hydrology and channel morphology but the influence of these changes on fundamental ecosystem processes of leaf litter breakdown and transport compared with those in nearby rural streams are poorly known. The widespread practice of planting exotic trees along riparian zones and street margins draining into urban streams further exacerbates the disruption of natural organic matter dynamics. The combination of seasonal leaf fall by exotic species and the altered drainage patterns through urbanization in Armidale, a regional town in New South Wales, Australia, resulted in contrasting patterns of benthic organic matter storage over 18 months compared to nearby reference and rural streams. Macroinvertebrate detritivore densities were low in the urban stream, implying disruption of the usual biological pathways of leaf breakdown. Understanding the interactions of hydrology, drainage pattern, leaf input and biological attribute of a stream is crucial for managers trying to restore stream ecosystem services without incurring public concern about the appearance of regional urban streams.