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AbstractRunning water ecosystems of Europe are affected by various human pressures. However, little is known about the prevalence, spatial patterns, interactions with natural environment and co‐occurrence of pressures. This study represents the first high‐resolution data analysis of human pressures at the European scale, where important pressure criteria for 9330 sampling sites in 14 European countries were analysed. We identified 15 criteria describing major anthropogenic degradation and combined these into a global pressure index by taking additive effects of multiple pressures into account. Rivers are affected by alterations of water quality (59%), hydrology (41%) and morphology (38%). Connectivity is disrupted at the catchment level in 85% and 35% at the river segment level. Approximately 31% of all sites are affected by one, 29% by two, 28% by three and 12% by four pressure groups; only 21% are unaffected. In total, 47% of the sites are multi‐impacted. Approximately 90% of lowland rivers are impacted by a combination of all four pressure groups.