The Nure and Trebbia catchments were affected by an extreme flood event on 13-14th September 2015. This study investigates the morphological responses to the flood of the Nure and Trebbia rivers and 18 tributaries with the aims to: i) quantify channel changes in width and pattern; (ii) identify the morphological and hydrological factors which might have driven channel response; (iii) quantify channel changes which have occurred after the flood event.Channel changes were characterized by field surveys and geomorphological analysis of multi-temporal orthophotos acquired before (2011), immediately after the flood (2015) and in 2020.In the tributaries, reach-scale channel widths after the flood reached up to 15 times their pre-flood values, whereas in the main channels the post/pre-flood width ratio attained a maximum value of 4. Augmented channel width in the main rivers was mostly associated with banks and islands erosion, whereas in the tributaries it was also due to deposition of coarse sediments onto the former floodplains. Islands were swept away in the main channels while both island erosion and formation occurred in the tributaries. In terms of channel pattern, pre-flood single-thread reaches displayed mainly multi-thread morphologies after the flood, mostly in response to a sudden input of coarse sediment supply. In the 5 yr following the flood, channels slightly narrowed but still remained wider than in 2011. The narrower reaches before the flood resulted to be the most sensitive to changes even some years after the flood.Statistical analyses between the channel width changes and a series of variables showed significant positive correlations with confinement index, channel slope, and the local storm rainfall depth. This study confirms how channel widening during large floods – usually neglected in flood hazard mapping and river basin management – is a very important process which must be considered in flood hazard assessment in mountain rivers.