Fine-grained sediment is a natural and essential component of river systems and plays a major role in the hydrological, geomorphological and ecological functioning of rivers. In many areas of the world, the level of anthropogenic activity is such that fine-grained sediment fluxes have been, or are being, modified at a magnitude and rate that cause profound, and sometimes irreversible, changes in the way that river systems function. This paper examines how anthropogenic activity has caused significant changes in the quantity and quality of fine-grained sediment within river systems, using examples of: land use change in New Zealand; the effects of reservoir construction and management in different countries; the interaction between sediment dynamics and fish habitats in British Columbia, Canada; and the management of contaminated sediment in USA rivers. The paper also evaluates present programmes and initiatives for the management of fine sediment in river systems and suggests changes that are needed if management strategies are to be effective and sustainable. Copyright © 2005 John Wiley & Sons, Ltd.