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Human-induced climate change is already apparent through warming temperatures, altered precipitation, and greater prevalence of extreme weather events (e.g., droughts and floods) all of which are anticipated to be exacerbated in the foreseeable future. Meanwhile, demand for hydropower generation is expected to increase and future hydropower developments will be important for mitigating climate change. Yet, climate change will affect the natural flow regimes, which will undoubtedly impact hydropower operations (e.g., storages and releases), and in turn the impact of altered hydropower operations on the discharge and consequence to fish that live in these regulated systems. Here, we synthesize the current knowledge of climate-induced alterations to hydropower operations and the expected impacts of altered hydropower operations on riverine fishes. We also consider what is needed to adapt to the way environmental threats will change over the typical 50–100 year lifespan of such facilities. Based on our synthesis, we anticipate the impact on native riverine fishes will increase in severity moving forward. Fortunately, we can take proactive measures to mitigate the adverse, yet synergistic, impacts of hydropower and climate change on aquatic ecosystems. Doing so will require extensive foresight, planning, and incorporating novel mitigation strategies into hydropower development. We also call for greater involvement of fisheries professionals in such processes to ensure that fish are not an afterthought. Failure to better consider how to future-proof hydropower in the context of climate change threatens not only fish populations but also the humans that depend on them for livelihoods, nutrition, and socio-cultural benefits. [ABSTRACT FROM AUTHOR]