River discharge depending on the dam gate operation method is an important factor underlying changes in estuarine sedimentation dynamics, but comprehensive studies are limited by data collection constraints. The hydrological operation of Nakdong Dam, designed to prevent seawater intrusion by opening during ebb tides and heavy rains and closing during flood tides, presents an ideal setting for such investigations. This study focused on the Nakdong River Estuary (NRE), utilizing aerial photography, bathymetry data, and sedimentation rate data to determine alterations in sediment transport and deposition patterns within the two tributary estuaries. Spatial discrepancies in sedimentation patterns across the eastern and western regions of the NRE were particularly evident in the spatial variations of textural characteristics and sedimentation rates. An enhanced ebb tidal prism resulting from dam gate opening in the eastern region caused the development of erosional topography and a rough depositional environment, forming a landward migrating (transgressive) barrier island system. Conversely, the predominantly closed dam gates in the western region maintained a consistent deposition pattern due to a regular tidal prism, facilitating the formation of sedimentary topography and fine sediment deposition. Consequently, barrier islands followed a seaward building (prograding) system. Therefore, the results suggested a role of modern dam gate operation as a major sedimentation mechanism, providing valuable insights for the sustainable management of estuarine sediment environments.