Stormwater impact guidelines for dissolved oxygen (DO) were applied to the Berlin River Spree, which (a) receives the effluents of more than 100 combined sewer discharge points and (b) is subject to significant anthropogenic background pollution. Discrimination of DO depressions, which are the direct result of combined sewer overflows (CSO) from DO depressions which are not related to CSO was achieved by combining stormwater impact guidelines with the analysis of data for: (i) rain events before critical DO depressions, (ii) water temperature (T) and conductivity as indicators for CSO impact in the river and (iii) T and DO before critical DO depressions to assess the effect of background pollution. Results indicate that the River Spree is in a critical state regarding DO for two main reasons: (a) upstream of the stretch with CSO discharge points because of background pollution and (b) downstream of the stretch because of CSO. Highly critical situations with DO < 2 mg L-1 only occurred under CSO influence. Nevertheless, the analysis underlines the importance of measures to reduce both CSO and background pollution in urban rivers.