The Las Vegas Wash is a dynamic channel system that drains the Las Vegas Valley (3,950 km2) into Lake Mead and the lower Colorado River, which provides drinking water to southern California, Arizona, and southern Nevada. In the last few decades the Las Vegas Wash has undergone massive changes in terms of channel degradation and bank erosion followed by recovery and restoration efforts. The evolution of the Las Vegas Wash is interlinked with urbanization, water use, and wastewater discharge. This article reviews the historical dynamics of the Las Vegas Wash in the context of restoration: evaluates the ongoing activities in the Las Vegas Wash against an established framework and success criteria; summarizes lessons learned; and discusses challenges. The ongoing activities in the Las Vegas Wash differ from other regional restoration projects in that there is a lack of an appropriate historical reference to which restoration goals should be targeted. Keys to the success of the Las Vegas Wash restoration and management program appear to be strong interagency collaboration, funding availability, effective outreach and monitoring efforts, and adaptive management strategies based on pragmatic urban values. There is a potential for realignment of existing resources for more practical ecological restoration goals.