Headwater streams are critical components of the stream network, yet landowner perceptions, attitudes, and property management behaviors surrounding these intermittent and ephemeral streams are not well understood. Our research uses the concept of watershed disproportionality, where coupled social-biophysical conditions bear a disproportionate responsibility for harmful water quality outcomes, to analyze the potential influence of riparian landowner perceptions and attitudes on water quality in headwater regions. We combine social science survey data, aerial imagery, and an analysis of spatial point processes to assess the relationship between riparian landowner perceptions and attitudes in relation to stream flow regularity. Stream flow regularity directly and positively shapes landowners' water quality concerns, and also positively influences landowners' attitudes of stream importance-a key determinant of water quality concern as identified in a path analysis. Similarly, riparian landowners who do not notice or perceive a stream on their property are likely located in headwater regions. Our findings indicate that landowners of headwater streams, which are critical areas for watershed-scale water quality, are less likely to manage for water quality than landowners with perennial streams in an obvious, natural channel. We discuss the relationships between streamflow and how landowners develop understandings of their stream, and relate this to the broader water quality implications of headwater stream mismanagement.