Rivers continue to be harnessed to meet humanity’s growing demands for electricity, water, and flood control. While the socioecological impacts of river infrastructure projects (RIPs) have been well-documented, methodological approaches to quantify river fragmentation and flow alteration vary widely in spatiotemporal scope, required data, and interpretation. In this review, we first present a framework to visualise the effects of different kinds of RIPs on river fragmentation and flow alteration. We then review available methods to quantify connectivity and flow alteration, along with their data requirements, scale of application, advantages, and disadvantages. Finally, we present decision-making trees to help stakeholders select among these methods based on their objectives, resource availability, and the characteristics of the project(s) being evaluated. Thematic searches of peer-reviewed literature using topic-relevant keywords were conducted on Google Scholar. The bibliography of selected papers was also reviewed, resulting in the selection of 79 publications. Papers that did not define or apply a specific metric were excluded. With respect to fragmentation, we selected papers focused on instream connectivity and excluded those dealing with overland hydrologic connections. For flow alteration, we selected papers that quantified the extent of alteration and excluded those aimed at prescribing environmental flows. The expected hydrological consequences of various RIP types were ‘mapped’ on a conceptual fragmentationflow alteration plot. We compiled 29 metrics of river fragmentation and 13 metrics to flow alteration, and used these to develop decision-making trees to facilitate method selection. Despite recent advances in metric development, further work is needed to better understand the relationships between and among metrics, assess their ecological significance and spatiotemporal scale of application, and develop more informative methods that can be effectively applied in data-scarce regions. These objectives are especially critical given the growing use of such metrics in basin-wide conservation and development planning.