Pressure retarded osmosis (PRO) has the potential to produce clean, renewable energy from natural salinity gradients. However, membrane fouling can lead to diminished water flux productivity, thus reducing the extractable energy. This study investigates organic fouling and osmotic backwash cleaning in PRO and the resulting impact on projected power generation. Fabricated thin-film composite membranes were fouled with model river water containing natural organic matter. The water permeation carried foulants from the feed river water into the membrane porous support layer and caused severe water flux decline of ∼46%. Analysis of the water flux behavior revealed three phases in membrane support layer fouling. Initial foulants of the first fouling phase quickly adsorbed at the active-support layer interface and caused a significantly greater increase in hydraulic resistance than the subsequent second and third phase foulants. The water permeability of the fouled membranes was lowered by ∼39%, causing ∼26% decrease in projected power density. A brief, chemical-free osmotic backwash was demonstrated to be effective in removing foulants from the porous support layer, achieving ∼44% recovery in projected power density. The substantial performance recovery after cleaning was attributed to the partial restoration of the membrane water permeability. This study shows that membrane fouling detrimentally impacts energy production, and highlights the potential strategies to mitigate fouling in PRO power generation with natural salinity gradients.