Equatorial East Africa experienced significant variations in paleoclimatic and paleoceanographic conditions during the Holocene. These environmental changes influenced sedimentation patterns on the continental shelf. To date, however, little is known about the sediment source, its transport to, and deposition on, the Tanzanian shelf. This paper presents a new high-resolution Holocene sedimentary record off northeast Tanzania (equatorial East Africa) and provides insights into how sedimentation patterns responded to climatic and oceanographic changes during the Holocene. Based on grain-size distribution patterns and mineral assemblages, three types of shelf sediments were identified: Type I (fine-grained terrigenous sediment) is dominated by clay minerals that originated from continental weathering; Type II (coarse-grained terrigenous sediment) is mainly composed of feldspar and quartz, derived from reworking of pre-existing deposits; and Type III (biogenic marine sediment), with low-and high-magnesium calcite, was produced by marine carbonate-secreting organisms. The high input of Type I sediment during the early Holocene (10–8 cal kyr BP) was caused by river mouth bypassing. This supply-dominated regime was controlled by intense river discharge and subsequent resuspension of mud in shelf settings, responding to the humid climate in the hinterland and sea-level rise with low rate off Tanzania. The first occurrence of Type II sediments was around 8 cal kyr BP and dominated when sedimentation rates lowered. This accommodation-dominated regime was caused by shoreface bypassing due to an arid climate and sea-level highstand. Type III sediments increased significantly from the early to late Holocene, resulting from the weakening dilution effect of the terrigenous component. The sedimentation pattern on the Tanzanian shelf shifted from allochthonous to autochthonous sedimentation constrained by climatic changes and relative sea-level fluctuations at the end of the early Holocene. Our results also suggest that, with respect to sea-level rise, high sedimentation rate on the continental shelf could be caused by high terrigenous sediment input as a result of a dynamic interplay between the shelf topography and humid climatic conditions inland.