River restoration is a novel paradigm of 'mirescape' (land-and-water-scape) management that developed along with the emergence of aquatic ecology. River restoration can be seen as the application of an ecological perspective to return rivers to nature. However, the river restoration paradigm is also the contemporary iteration of historical phases of mirescape management. We review the long and varied recorded history of the Po River in northern Italy as a case study to illustrate the transformations and common themes of mirescape management. We find, first, that significant changes in mirescape management and river condition only occur in the context of larger social, political, technological and economic transformations. Second, we show how particular cultural understandings, economic interests, technological innovations and political powers have driven particular paradigms of mirescape management. These have tended towards increasing territorial separation of wet and dry. We find, third, that these separations lead not only to increasing economic precariousness for many, but also to increasingly severe disasters. We conclude that river restoration faces social and political challenges to becoming relevant at a mirescape scale, due to its lack of integration with land management, or with current social, political, technological and economic transformations. To act on this conclusion, we suggest philosophically aligned social movements that river restoration could work with to improve impact and uptake.