Increasing urbanization has profound impacts on freshwater ecosystems. Stream restoration and enhancement can improve the physiochemical and ecological conditions of degraded urban streams. However, restoration in urban streams is complicated by land ownership, floodplain development and urban infrastructure. To maximize the benefits of stream restoration practices with limited resources, we prioritized degraded streams for intervention based on their restoration potentials. We developed a stream restoration prioritization tool to identify streams with the greatest restoration potential in the Southeast Piedmont of the United States, a region that has experienced rapid urbanization, by using structural equation modeling (SEM) with data from the USGS Southeast Stream Quality Assessment (SESQA) dataset. The dataset was used for model development and the macroinvertebrate multi-metric index (MMI) was used to measure stream health level. Moreover, we developed a weighted metric to quantify the model predicted efforts to restore a stream, which can help managers to prioritize streams. Finally, by applying the tool to streams (n=75) in the Southeast Piedmont, we identified degraded streams with the greatest restoration potential and demonstrated the usefulness of SEM in combination with the developed weighted metric in prioritizing streams for ecological enhancement and proposing potential strategies.