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The San Pedro River originates in Sonora, Mexico, and flows north through Arizona, USA, to its confluence with the Gila River. The 92-km Upper San Pedro River is characterized by interrupted perennial flow, and serves as a vital wildlife corridor through this semiarid to arid region. Over the past century, groundwater pumping in this bi-national basin has depleted baseflows in the river. In 2007, the United States Geological Survey published the most recent groundwater model of the basin. This model served as the basis for predictive simulations, including maps of stream flow capture due to pumping and of stream flow restoration due to managed aquifer recharge. Simulation results show that ramping up near-stream recharge, as needed, to compensate for downward pumping-related stress on the water table, could sustain baseflows in the Upper San Pedro River at or above 2003 levels until the year 2100 with less than 4.7 million cubic meters per year (MCM/yr). Wet-dry mapping of the river over a period of 15 years developed a body of empirical evidence which, when combined with the simulation tools, provided powerful technical support to decision makers struggling to manage aquifer recharge to support baseflows in the river while also accommodating the economic needs of the basin.