The operation of the Three Gorges Dam (TGD) modifies downstream flow and sediment regimes, triggering disproportional fluvial responses at different distances downstream. However, our understanding of the downstream geomorphic changes in the middle-lower Yangtze River remains incomplete due to the complexity of the river responses across temporal and spatial scales. Here, we leverage data on discharge, suspended sediment concentration (SSC), riverbed grain size, cross-sectional profiles and high-resolution channel bathymetric maps at different locations downstream of the TGD to investigate geomorphic responses. The results show that the magnitude of fluvial erosion decreases downstream, with the Yichang-Luoshan Reach (the first ~500 km downstream) experiencing the most severe erosion in 2003–2020 (~9.05 × 104 t/km/yr). Local changes in riverbed morphology include channel bar erosion, channel incision (~0.43 m/yr in CS1 near the dam site over 2002–2019), riverbank retreat and bed material coarsening (an increase in D50 from 0.175 to 43.1 mm at Yichang station from 2002 to 2017). Such marked erosion is caused by the sharply reduced SSC in the dominant discharge range (10,000–30,000 m3/s) and the extended duration of this dominant discharge range. The sediment erosive magnitude in the Luoshan-Datong Reach is relatively small (3.85 × 104 t/km/yr) in 2002–2020. The Luoshan-Hukou Reach (~500–1000 km downstream) exhibits moderate channel incision, minor bed material coarsening and moderate mid-channel bar lateral erosion. The Hukou-Datong Reach (below 1000 km downstream) experienced minor geomorphic change without significant evidence of bed material coarsening. The relatively small impact of the TGD on the lower reach from Luoshan to Datong can be mainly attributed to the progressive SSC recovery along the river induced by upstream channel erosion providing sediment replenishment. These findings have significant implications for estimating geomorphic changes in response to upstream damming and thus could inform better river management and ecological assessment in other similar alluvial rivers.