Tidal flat plays an important role in coastal development because of its ecological and spatial resources. We take the southern tidal flat in the macro-tidal turbid Hangzhou Bay as an example to study the long-term (1990–2020) evolution of the muddy tidal flat, using remote sensing data and field observational data. The detailed bathymetric elevation of the tidal flat is obtained, using remote sensing images of Landsat and Sentinel-2, combined with the real-time kinematic (RTK) data. The correlation coefficient between the remote sensing data and the RTK data is 0.73. The tidal flat and vegetation areas are affected by reclamation. The total tidal flat area decreased by 467.78 km2. The vegetation area declined from 64.98 km2 in 2000 to 13.41 km2 in 2015 and recovered to 41.62 km2 in 2020. The largest change in tidal flat slope occurs in the eastern and western sides of the tidal flat, compared with the wide middle part. The total length of tidal creeks decreased to 45.95 km in 2005 and then increased to 105.83 km in 2020. The middle- and low-grade tidal creeks accounted for 91.4%, with a curvature slightly larger than 1 in 2020. High-grade tidal creeks occur inside the vegetation areas, with less bending and fewer branch points. Vegetation promotes the development of tidal creeks but limits the lateral swing and bifurcation. These results provide a basis for the management of global tidal flat resources and ecosystems.