Reconciling the needs of nature and people in California's Sacramento - San Joaquin River Delta represents one of the most critical ecosystem management imperatives in western North America. Over 150 years the Delta has been managed for near-term human benefits and in the process 95% of riverine and deltaic wetlands have been lost throughout the region. Despite extensive land conversion and alteration of hydrological and physical processes, the Delta remains important habitat for migratory birds and is home to over 60% of California's native fish species. It is also the waterwheel for the state's vast water distribution network and is maintained by a system of constructed levees that are at risk from catastrophic failure due to sea level rise, floods, and/or seismic activity. Such a collapse would have dire consequences for > 25M humans and world's 10th largest economy that depend on its freshwater. Thus, the ultimate cost of this ecosystem alteration and simplification is a riverscape that is no longer reliable for nature or people. For 30 years, attempts to 'restore' Delta ecosystems and improve reliability have met with mixed results. For example, reconnection of floodplains to floodwaters has resulted in improved ecological health for native fishes and recharge to localized aquifers. Uncoordinated releases of discharges below dams, however, have resulted in diminished water quality and populations of indicator species. Attempts to create wildlife friendly farms have been countered by an increase in perennial agriculture and commensurate increases in irrigation water demand. From these lessons learned, we demonstrate three key components of a reconciled Delta that will be necessary in the future: 1) full restoration of critical habitats, reconnecting land and water to rebuild ecosystem function; 2) landscape redesign, incorporating natural and engineered infrastructure to create a biologically diverse, resilient landscape to support both agriculture and natural ecosystems, while reducing the impacts of climate change; and 3) recognition that some ecosystem components, including less resilient species, may be lost and other novel components may emerge. These findings serve to reconcile conflicting demands and restoring ecosystem functions in highly altered wetland landscapes worldwide.