Currently, Southeast Europe (SEE) is witnessing a boom in hydropower plant (HPP) construction, which has not even spared protected areas. As SEE includes global hotspots of aquatic biodiversity, it is expected that this boom will result in a more severe impact on biodiversity than that of other regions. A more detailed assessment of the environmental risks resulting from HPP construction would have to rely on the existence of nearby hydrological and biological monitoring stations. For this reason, we review the distribution and trends of HPPs in the area, as well as the availability of hydrological and biological monitoring data from national institutions useable for environmental impact assessment. Our analysis samples tributary rivers of the Danube in Slovenia, Croatia, Bosnia and Herzegovina, Serbia, and Montenegro, referred to hereafter as TRD rivers. Currently, 636 HPPs are operating along the course of TRD rivers, most of which are small (<1 MW). An additional 1315 HPPs are currently planned to be built, mostly in Serbia and in Bosnia and Herzegovina. As official monitoring stations near HPPs are rare, the impact of those HPPs on river flow, fish and macroinvertebrates is difficult to assess. This manuscript represents the first regional review of hydropower use and of available data sources on its environmental impact for an area outside of the Alps. We conclude that current hydrological and biological monitoring in TRD rivers is insufficient for an assessment of the ecological impacts of HPPs. This data gap also prevents an adequate assessment of the ecological impacts of planned HP projects, as well as the identification of appropriate measures to mitigate the environmental effects of existing HPPs.