Urbanization in watersheds is known to alter water chemistry and hydrology, which can subsequently impact macroinvertebrate communities. Additionally, sedimentation, often linked to human activities such as agriculture and construction, can further exacerbate these effects. In this study, we compared the macroinvertebrate communities of two small stream systems that differ in urbanization levels. The first site, Castleman’s Run, is a forested stream and a third-order tributary of Buffalo Creek, while the second site, Long Run, is located in a highly urbanized area and is a second-order tributary of Wheeling Creek. Using multi-year water chemistry data and macroinvertebrate sampling, we evaluated trends in water quality and examined differences in macroinvertebrate communities between the two sites. We also provided an overall assessment of stream health for both Castleman’s Run and Long Run. Macroinvertebrate samples were identified to the family level, which allowed us to assess group-specific tolerance values and better understand their relationship to ecosystem quality.