Persistence of tidal wetlands under conditions of sea level rise depends on vertical accretion of organic and inorganic matter, which vary in their relative abundance across estuarine gradients. We examined the relative contribution of organic and inorganic matter to vertical soil accretion using lead-210 (210Pb) dating of soil cores collected in tidal wetlands spanning a tidal freshwater to brackish gradient across a Chesapeake Bay subestuary. Only 8 out of the 15 subsites had accretion rates higher than relative sea level rise for the area, with the lowest rates of accretion found in oligohaline marshes in the middle of the subestuary. The mass accumulation of organic and inorganic matter was similar and related (R2 = 0.37). However, owing to its lower density, organic matter contributed 1.5–3 times more toward vertical accretion than inorganic matter. Furthermore, water/porespace associated with organic matter accounted for 82%–94% of the total vertical accretion. These findings demonstrate the key role of organic matter in the persistence of coastal wetlands with low mineral sediment supply, particularly mid-estuary oligohaline marshes.