As the global demand for renewable electricity grows, hydropower development of river basins increases across the world. Hydropeaking, i.e., streamflow alteration consisting of daily or subdaily rapid and marked discharge fluctuations, can affect river reaches below hydropower units. Environmental effects of hydropeaking include geomorphological alterations and possible modifications of the freshwater biota. Among affected instream communities, benthic macroinvertebrates are receiving increasing attention and the related scientific research has experienced significant progress in the last decade. In this context, this paper aims to summarize state-of-the-art methods for the assessment of hydropeaking impacts on benthic macroinvertebrate communities. The present review could support the proper design of monitoring plans aimed at assessing the ecological impacts of hydropeaking and the effects of possible mitigation strategies.