Marsh lateral expansion and retreat are often attributed to sediment availability, but a causal link is difficult to establish. To shed light on this problem, we analyzed changes in salt marsh area along the ~ 200-km-long Georgia coast (USA) from the 1850s to 2010s in relation to total suspended sediment (TSS) and to proxies for river sediment input and local sediment resuspension. Marsh area is characterized by large gains and losses (up to 200 m2/m/yr), but relatively small net change (-50 to 50 m2/m/yr or -0.1 to 0.1%/yr). This has resulted in a general loss of marsh area, except close to the mouths of major rivers, where there is net gain. Net expansion rates decreased in the Savannah Estuary but increased in the Altamaha Estuary from the 1850s–1930s period to the 1930s–2010s period, which are consistent with observed decreases and likely increases in sediment discharge in the two estuaries, respectively. To explain the spatial patterns in the 1930s–2010s marsh area change, we estimated TSS from satellite measurements (2003 to 2020). Along the northern part of the Georgia coast, net marsh gain is positively correlated to the average TSS within the estuarine region. However, this correlation breaks down in more southern areas (Cumberland Sound). Coast-wide, there is a better correlation between TSS associated with new input from the rivers, estimated as the TSS difference between high-discharge (Jan–Mar) and low-discharge (Sept–Nov) months. To identify the effect of wave resuspension in the nearshore, we consider the TSS difference between high-wave, low-discharge (Sept–Nov) and low-wave, low-discharge periods (Jun–Aug). Wave resuspension is relatively uniform along the coast and does not explain spatial patterns of marsh area change. Sediment input from the nearshore is likely contributing to the estuarine sediment budget in Georgia, but it is not sufficient to prevent marsh lateral retreat. To identify the role of tidal resuspension and advection, we consider differences in TSS between low and high tide. This differential is relatively constant along most of the coast, but it is much lower in the southern part of the coast, suggesting a lower tidal action in this region. Sediment resuspended by tides is likely originating from internal recycling (i.e., erosion) within the estuary, and thus does not contribute to marsh lateral expansion. The proposed approach to partition TSS is a general demonstration and could be applied to other coastal regions.