Agricultural pesticides are widely used and can affect freshwater organisms. We applied a spatially explicit exposure model, validated for central Europe, to estimate exposure to insecticides through runoff for streams in south-eastern Australia. The model allows the identification of streams potentially affected by insecticide runoff located in 10 × 10 km grid cells. The computation of runoff relies on key environmental factors such as land use, soil texture, slope and precipitation. Additionally, the model predicted the ecological effect of insecticides on the macroinvertebrate community. We predicted insecticide surface runoff that results in a moderate to poor ecological quality for streams in half of the grid cells containing agricultural land. These results are in good accordance with the results obtained by estimating pesticide stress with a biotic index (SPEAR_pesticides) based on macroinvertebrate monitoring data. We conclude that the exposure and effect model can act as an effective and cost-saving tool to identify high risk areas of insecticide exposure and to support stream management.