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The protection of headwater streams faces increasing challenges, exemplified by limited global recognition of headwater contributions to watershed resiliency and a recent US Supreme Court decision limiting federal safeguards. Despite accounting for ~77% of global river networks, the lack of adequate headwaters protections is caused, in part, by limited information on their extent and functions—in particular, their flow regimes, which form the foundation for decision-making regarding their protection. Yet, headwater streamflow is challenging to comprehensively measure and model; it is highly variable and sensitive to changes in land use, management and climate. Modelling headwater streamflow to quantify its cumulative contributions to downstream river networks requires an integrative understanding across local hillslope and channel (that is, watershed) processes. Here we begin to address this challenge by proposing a consistent definition for headwater systems and streams, evaluating how headwater streamflow is characterized and advocating for closing gaps in headwater streamflow data collection, modelling and synthesis.