The environmental impact assessment is a process required in many countries. It highlights future activities with a significant impact on the environment. Water, as an environmental factor, needs adequate methods for quantifying cumulative impact of hydrotechnical works. In most cases, for new developments, baseline data is collected before the beginning of the construction, but for waterworks already in place, a different approach is needed. In line with the EU Water Framework Directive (Directive 2000/60/EC), the overall purpose of the research is to develop an approach for the hydromorphological cumulative impact assessment integrating different spatial scales for existing water intakes with transversal barriers on mountain rivers in Romania. Being a research study developed for a specific issue—post-construction impact assessment, some innovative actions were required. Lack of information in the pre-construction phase was an important constraint. Customizing formulas of certain indicators established within the Romanian method for hydromorphological status assessment of rivers proved to be a practical solution to show both local and waterbody hydromorphological impact. Upscaling the impact from the local scale to the river sector and the waterbody allows awareness of the spatial extent of the impact and understanding of the importance of the thresholds of significant impact for a broader audience. In order to better highlight the approach, this paper shows practical examples. The whole chain of the drivers–pressures–state–impacts–responses (DPSIR) framework is applied in the case of two river water bodies with hydropower generation facilities in place. In addition, some recommendations for actions are provided.