The Richmond River forms a significant part of the coastal region of New South Wales (NSW) Australia, and is of great environmental, social and economic importance. The history river reflects its role in providing the needs upon which human life depends – water, fertile soil and food. Paradoxically, human impact since colonisation have threatened those elements. The establishment of settlements on the river reflected the needs at the time, which influenced the transformation that accompanied socio-economic use. Such changes have often been pursued to serve one particular outcome, such as flood mitigation, disregarding its effect elsewhere. The accumulated impact of settlement and land use and the development of its catchment and floodplains are reflected in the state of the river and inscribed in archival records, newspapers, reports and scientific research. Drawing on those records, this paper describes the historical transformation of the river and floodplain and consequences of these actions on catchment and river health.