The purpose of this document is to identify and provide design guidelines for bridge scour and stream instability countermeasures that have been implemented by various State departments of transportation (DOTs) in the United States. Countermeasure experience, selection, and design guidance are consolidated from other FHWA publications in this document to support a comprehensive analysis of scour and stream instability problems and provide a range of solutions to those problems. The results of recently completed National Cooperative Highway Research Program (NCHRP) projects are incorporated in the design guidance, including: countermeasures to protect bridge piers and abutments from scour; riprap design criteria, specifications, and quality control, and environmentally sensitive channel and bank protection measures. Selected innovative countermeasure concepts and guidance derived from practice outside the United States are introduced.