It is unclear whether differentiating live and dead diatoms would enhance the accuracy and precision of diatom-based stream bioassessment. We collected benthic diatom samples from 25 stream sites in the Northern Oregon Coast ecoregion. We counted live diatoms (cells with visible chloroplasts) and then compared the counts with those generated using the conventional method (clean counts). Non-metric multidimensional scaling (NMDS) showed that the diatom assemblages generated from the two counts were overall similar. The relationships between the two diatom assemblages (summarized as NMDS ordination axes) and the environmental variables were also similar. Both assemblages correlated well with in-stream physical habitat conditions (e.g., channel dimensions, substrate types, and canopy cover). The conventional diatom method provides taxonomic confidence while the live diatom count offers ecological reliability. Both methods can be used in bioassessment based on specific assessment objectives.