The Chesapeake Bay receives nearly 1 000 000 tonnes of sediment annually from its major tributary, the Susquehanna River. The pattern of deposition of this sediment affects the lifetime of the estuarine resource and the fate of any sediment-borne contaminants. Previous estimates of the extent to which Susquehanna River sediment is transported down the Chesapeake have differed considerably. By use of reactor-generated radionuclides adsorbed on the river sediment, a sediment budget has been compiled for the upper Chesapeake Bay and the reservoirs on the lower Susquehanna. Reservoirs impound nearly 1 400 000 tonnes of sediment annually behind the power dams on the lower Susquehanna River. Without the dams, sediment delivery to the upper bay would more than double. The uppermost Chesapeake Bay, within and above the turbidity maximum, retains virtually all of the fluvial sediment delivered to it. The result is an annual sedimentation rate of approximately 3 mm yr−1 in the upper bay, an infilling rate that is nearly equal to the regional rate of sea level rise.