Sediment transport within small tidal inlets is sensitive to natural processes, whilst large tidal inlets are relatively robust systems because of their large tidal prism. However, remarked morphological changes may be initiated even under the condition of low sediment supply, as illustrated by Jiaozhou Bay, a large coastal embayment on the Shandong Peninsula, eastern China. Jiaozhou Bay is characterized by its relatively slow rate of natural change, and while the embayment has a flood-dominated entrance channel and muddy seabed, the suspended sediment concentration is generally low due to the lack of abundant source material. Observations of sediment dynamics show that net suspended sediment transport is directed towards outside of the bay, with an order of magnitude of 103t during a tidal cycle. The export of sediment associated with this flood-dominated environment implies that the net transport pattern is controlled by tidal exchange processes rather than the strength of the seabed shear stress. Sediment budget calculations show that supply of artificial sediment into the bay can account for up to 72% of the total input, which is in agreement with the 210Pb and 137Cs radioisotope geochronologies, and this leads to accumulation rates of 100–101mmyr−1; without this, the deposition rate would be low under natural conditions. The flood tidal delta area is also influenced by the input of anthropogenic material, and acts as a depocenter with relatively high accumulation rates. Furthermore, although the inlet system has not yet reached its equilibrium state (i.e., the entrance cross-sectional area is still larger than the equilibrium cross-sectional area), land reclamation activities have resulted in a rapid reduction of the embayment area (by 37%) over the last 80 years. Our findings indicate that the rapid changes observed in the tidal basin area and seabed morphology are mainly the result of human activity rather than natural processes.