The amount, patterns, and particle size composition of suspended sediment in the upper Changjiang Basin has been altered significantly due to the cascade reservoirs construction. A dam breach may disrupt sedimentation in the reservoir, channel erosion downstream of the dam, and the cycle of nutrients and contaminants adherent to the dam. This study is based on the long time-series field data of water discharge, sediment flux, and suspended sediment grain size of the upper Changjiang River Basin from 1973 to 2019. Four significant stepwise reduction periods in sediment load were identified by employing the M-K test, namely, 1973–1992, 1993–2002, 2003–2012, and 2013–2019. Based on the results, sediment load reduction in the upper Changjiang River (CJR) is remarkably correlated with an increase in the capacity of large reservoirs. Jialingjiang River became the largest sediment source area for upper CJR in 2013–2019. Moreover, the variation range of suspended sediment median particle size gradually narrowed with decreasing sediment load during the four periods in the upper CJR. The silt content of suspended sediment increased while clay and sand contents decreased which would maybe a factor of decreasing of P flux in the upper CJR. After the impounding of the Xiangjiaba and Xiluodu Reservoirs in the Jinshajiang River, the fining trend of suspended sediment along the main stem of upper CJR was cut off in 2013–2019, which may be ascribed to sediment management of the cascade reservoirs regulation and the sediment resuspension from the channel erosion in the river downstream. These observations can also serve as a reference for future studies about the effects of cascade reservoirs on aquatic ecology and environmental changes.