Changes in climate are driving an intensification of the hydrologic cycle and leading to alterations of natural streamflow regimes. Human disturbances such as dams, land-cover change, and water diversions are thought to obscure climate signals in hydrologic systems. As a result, most studies of changing hydroclimatic conditions are limited to areas with natural streamflow. Here, we compare trends in observed streamflow from natural and human-modified watersheds in the United States and Canada for the 1981–2015 water years to evaluate whether comparable responses to climate change are present in both systems. We find that patterns and magnitudes of trends in median daily streamflow, daily streamflow variability, and daily extremes in human-modified watersheds are similar to those from nearby natural watersheds. Streamflow in both systems show negative trends throughout the southern and western United States and positive trends throughout the northeastern United States, the northern Great Plains, and southern prairies of Canada. The trends in both natural and human-modified watersheds are linked to local trends in precipitation and reference evapotranspiration, demonstrating that water management and land-cover change have not substantially altered the effects of climate change on human-modified watersheds compared with nearby natural watersheds.