This paper describes a study to determine sediment transport processes and morphodynamics of the Tanaro River in northwestern Italy to support river management strategies. An integrated hydraulic-geomorphic approach was used to: (a) assess geology, land use and climate controls affecting sediment yield at the catchment scale; (b) evaluate changes in channel morphology and sediment transport processes; (c) model river channel change. Numerical simulations were used to evaluate the transient solution for flow and bed profile due to the propagation of the flood wave. It is concluded that Alessandria town is the most critical reach from the flooding point of view and so different design solutions were tested in order to verify whether geometric alteration of the river bed would allow for an increase in flood capacity.