Sinuous deep-water channels display a wide range of geometries and internal architectures. Most modern examples have been documented from large passive-margin fans, supplied by major rivers carrying huge volumes of dominantly fine-grained sediments, e.g. Amazon, Mississippi, Zaire, Bengal, Indus, Rhône and Nile Fans. However, similar examples have also been documented from tectonically active margins, e.g. Magdalena Fan. In most cases, modern sinuous channels comprise the core element of laterally extensive channel–levee systems that often aggrade significantly above a low-gradient (0.1–0.5°) fan surface; individual channels may extend downslope for 100s of kilometres. Typically, channels are subject to frequent avulsions, with only one channel active at any given time. Present highstand conditions have ensured that activity in many modern sinuous channels is much reduced due to the disconnect between fluvial feeder system and canyon head, and some have even been heavily modified or destroyed by major mass-transport deposits. Exceptions include Zaire Fan, where recent activity has provided useful insights into flow processes. The majority of detailed studies relating to sinuous channels in the subsurface originate from offshore west Africa, where channels typically occur within incisional (confined) slope–channel complexes and often represent the latter stages of channel complex fill. Both dominantly aggradational and laterally migrating styles are recognised, while modern seafloor channels in this region display a similar incisional character, e.g. Cap Timiris Canyon. Morphologic expression of sinuosity is harder to recognise at outcrop, but there are an increasing number of documented examples of lateral accretion deposits, representing point-bar growth, that are currently thought to be diagnostic of sinuous channel forms. Sinuous channel lateral migration, and point-bar growth, appears to be driven by sustained flow of fluvial-sourced (probably hyperpycnal) low-density turbidity currents, although there does appear to be variation in energy conditions, with some outcrop examples showing switches in erosive and depositional phases of activity. Previous studies have frequently focussed on the obvious gross planform morphologic similarities between fluvial and deep-water sinuous channels, e.g. nature of sinuosity, presence of point bars and cut-off loops. However, we suggest here that the differences between submarine and river channels are of greater significance, in terms of geometry, flow processes, migration style and deposit character. Sinuous deep-water channels typically form initially by a moderate amount of incision followed by rapid initial bend growth (associated with bypass of sediment). Channels that show significant aggradation then reach a point where there is a near cessation of planform movement (ossification), and growth is dominated by vertical aggradation. A new process model is proposed for this developmental sequence that synthesises observations and experiments that were previously paradoxical.