A new generation of hydropower technologies, the kinetic hydro and wave energy conversion devices, offers the possibility of generating electricity from the movements of water, without the need for dams and diversions. The Energy Policy Act of 2005 encouraged the development of these sources of renewable energy in the United States, and there is growing interest in deploying them globally. The technologies that would extract electricity from free-flowing streams, estuaries, and oceans have not been widely tested. Consequently, the U.S. Department of Energy convened a workshop to (1) identify the varieties of hydrokinetic energy and wave energy conversion devices and their stages of development, (2) identify where these technologies can best operate, (3) identify the potential environmental issues associated with these technologies and possible mitigation measures, and (4) develop a list of research needs and/or practical solutions to address unresolved environmental issues. We review the results of that workshop, focusing on potential effects on freshwater, estuarine, and marine ecosystems, and we describe recent national and international developments.