The Mid-Atlantic Highlands Assessment (MAHA) included the sampling of macroinvertebrates from 424 wadeable stream sites to determine status and trends, biological conditions, and water quality in first through third order streams in the Mid-Atlantic Highlands Region (MAHR) of the United States in 1993-1995. We identified reference and impaired sites using water chemistry and habitat criteria and evaluated a set of candidate macroinvertebrate metrics using a stepwise process. This process examined several metric characteristics, including ability of metrics to discriminate reference and impaired sites, relative scope of impairment, correlations with chemical and habitat indicators of stream disturbance, redundancy with other metrics, and within-year variability. Metrics that performed well were compared with metrics currently being used by three states in the region: Pennsylvania, Virginia, and West Virginia. Some of the metrics used by these states did not perform well when evaluated using regional data, while other metrics used by all three states in some form, specifically number of taxa, number of EPT taxa, and Hilsenhoff Biotic Index, performed well overall. Reasons for discrepancies between state and regional evaluations of metrics are explored. We also provide a set of metrics that, when used in combination, may provide a useful assessment of stream conditions in the MAHR.