Mercury (Hg) concentrations normalized to their dominant hosts have been widely used to identify geological events such as massive volcanic eruptions. However, the modern Hg cycle has significantly changed, and the implications of host-normalized Hg concentrations for the Hg dynamics in contemporary coastal environments (e.g., sources, delivery mechanisms, and Hg fluxes) remain poorly understood. In this study, 66 surface sediment samples from the continental shelf of the East China Sea (ECS) were analyzed, and the total organic carbon (TOC), aluminum (Al), total sulfur (TS), and Hg concentrations were determined. Our results support that organic matter predominantly hosts Hg in these sediments. Factors such as the Hg source and abundances of organic fractions influence Hg distributions, with notable enrichment in the Changjiang River estuary and the inner shelf of the ECS, especially near the mud depocenter located off the Oujiang River estuary. The oxic to suboxic redox state and the lack of significant sulfide accumulation in surface sediments suggest that sulfides are not the primary Hg hosts. The Hg/TOC ratios, ranging from 3.0 to 169.6 (ppb/%), are particularly high in the Changjiang River estuary and exhibit an exponential correlation with the Hg accumulation rates (Hg-AR). These findings suggest that the host-normalized Hg concentration could serve as a valuable tool for assessing Hg dynamics where the accumulation rates are uncertain.