The freshwater environment in Ethiopia is exposed to severe human influence because of fast population growth and other factors. Anthropogenic activities in developing countries such as river regulation and pollution have a potentially negative cumulative impact on water quantity and quality of the rivers and wetlands, hence negatively impacting benthic invertebrates and fishes. This review aims to identify the impacts of fine sediment on the community of benthic macroinvertebrates, and freshwater food webs, and to assess the response of benthic invertebrates to fine sediment pollution. Literature review was used as a methodology. Fine segment load on the freshwater ecosystem from both point and nonpoint sources may directly/indirectly alter the macroinvertebrate communities. Organic and inorganic contaminants as well as other sediment variables (sediment grain size, total organic carbon, nutrients, etc.) were affecting the community composition of benthic invertebrates. However, habitat features like the number of supplements or the silt grain measure clarify the variation in macroinvertebrate indices and metrics. The impact of metals and, to a lesser extent, organic contaminants may also be significant. Benthic macroinvertebrates are commonly used indicators of river ecological conditions that can be adversely affected by fine sediment loads. Sedimentation can change the suitability of the substrate for some taxa, increase macroinvertebrate drift, and affect respiration and feeding. To conclude, excessive fine sediment severely alters the structure and function of macroinvertebrates. At the regional and national levels, different governmental and non-governmental organizations, research institutions, and policy makers are recommended to take responsibility for reducing sediment discharge to the freshwater ecosystem by applying different conservation measures of benthic macroinvertebrates.