Spring creeks are highly prone to degradation from anthropogenic (e.g., grazing-related) sediment, yet little is known to guide sediment reduction through restoration. This long-term study explored associations of basic channel form with riffle substrates and trout spawning site quality, along with nine macroinvertebrate taxa groups and two biotic indices in four actively restored (reconstructed with > 10 years rest from livestock grazing) and four unrestored (damaged by land use, including riparian livestock grazing) spring creeks in western Montana. Despite no change in channel slope, riffles in restored streams had lower width-to-depth ratios (10.2 ± 1.8 versus 19.2 ± 4.6), higher velocities (0.71 ± 0.18 versus 0.39 ± 0.09 m/s), lower percentage of sediment < 6.3 mm (25.9 ± 6.6 versus 41.4 ± 6.2) and higher quality spawning sites than unrestored streams. These results suggest stream restoration can improve spawning substrate by facilitating sediment transport via reduced width-to-depth ratio. When all streams were considered, the richness of sediment-tolerant macroinvertebrates were inversely correlated with riffle substrate size; whereas, clinger (sediment-intolerant) richness correlated positively with riffle substrate size. Of the two biotic indices, the Montana Mountains and Foothills Biotic Index showed no correlation to the nine taxa groups. Whereas, a significant correlation of the Fine Sediment Biotic Index with sediment < 6.35 mm suggests it may be a better indicator of spring creek habitat integrity and restoration effectiveness.