The third largest river in Syria, the Nahr el Kebir has a well-preserved record of river-terrace deposits that have produced substantial Palaeolithic artefact assemblages both from within the terrace deposits and from the land surfaces above and around them. At the Mediterranean coastline, the fluvial gravels interdigitate with raised shoreline terrace deposits, providing an insight into the temporal and climatic relations of both of these important geomorphological and morphostratigraphical archives, as well as their relationship with each other. New research is reported here on the Pleistocene geology and geomorphology of the Nahr el Kebir and the associated Palaeolithic archaeology, the latter having been reinterpreted based on reassessment of museum collections arising from earlier detailed work. Field visits revealed an additional, hitherto unrecognized low-level river terrace, whereas one of the previously recognized Palaeolithic levels can be shown to coincide with slope deposits that armour hilltops rather than representing a genuine fluvial formation. The new understanding of these geomorphological and sedimentary archives supports ideas that this corner of the Mediterranean has experienced unusually rapid uplift during the recent Quaternary, as a result of which the local rivers, including the Kebir, have deepened their valleys rapidly. Consequently, only the recent part of the Quaternary is recorded in the Kebir system and the ages envisaged previously for the terrace deposits and the Palaeolithic artefact assemblages were considerable overestimates in many cases, a finding that has significance for their correlation with those from the wider region. Reassessment of the Palaeolithic archaeology suggests a settlement history initially dominated by groups using handaxes, alongside simple core working (0.5–0.3 Ma), followed by a major change with the appearance of Levallois core working alongside handaxes, marking the transition to the early Middle Palaeolithic.