The diverse lagoons and coastal lakes along the east coast of South Africa occupy incised valleys that were flooded during the rise and subsequent stabilisation of relative sea-level during the Holocene. Sedimentary deposits contained within these waterbodies provide an opportunity to investigate complex hydrological and sedimentological processes, and examine sea-level controls governing system geomorphic evolution. In this paper, we combine diatom and sulfur isotope analyses from two sediment cores extracted from the northern sub-basins of Lake St Lucia, a large shallow estuarine lake that is today largely isolated from direct ocean influence behind a Holocene-Pleistocene barrier complex. Analyses allow the reconstruction of hydrological changes associated with the geomorphic development of the system over the mid-to late Holocene. The sedimentary sequences indicate that St Lucia was a shallow, partially enclosed estuary/embayment dominated by strong tidal flows prior to ∼6200 cal. BP. Infilling was initiated when sea-level rise slowed and stabilised around present day levels, resulting in the accumulation of fine-grained sediment behind an emergent proto-barrier. Diatom assemblages, dominated by marine benthic and epiphytic species, reveal a system structured by marine water influx and characterised by marsh and tidal flat habitats until ∼4550 cal. BP. A shift in the biological community at ∼4550 cal. BP is linked to the development of a back-barrier water body that supported a brackish community. Marine planktonics and enrichments in δ34S suggest recurrent, large-scale barrier inundation events during this time, coincident with a mid-Holocene sea-level highstand. Periodic marine incursions associated with episodes of enhanced storminess and overwash remained prevalent until ∼1200 cal. BP, when further barrier construction ultimately isolated the northern basins from the ocean. This study provides the first reconstruction of the palaeohydrological environment at Lake St Lucia and highlights the long-term geomorphic controls that have shaped the recent evolution and natural dynamics of the system. Unlike most coastal lake systems, this system is particularly effective as an archive of geomorphological change. Systems driven by back-barrier modifications, such as Lake St Lucia, highlight how geomorphological changes driven by sediment-supply, climate and sea level can be distributed unevenly over several isolated back-barrier basins.