The processes controlling tufa deposition along the River Mesa (NE Spain) were studied from April 2003 to September 2009, based on six-monthly monitoring of physical and chemical parameters of the river water and sedimentological characteristics, including deposition rates on tablets. With a mean annual discharge around 1.5m3/s, the sedimentation rate (mean 2mm/yr) recorded important spatial, seasonal and interannual variations. The river waters are of the calcium bicarbonate type. In this study, three distinct river stretches were distinguished based on the steady groundwater inputs, some of low-thermal nature. Groundwater discharges controlled the water chemical composition, and some sedimentation features too. At each stretch, an increase in pCO2 and conductivity was measured around the spring sites. Decreasing trends in conductivity or alkalinity with high enough saturation values with respect to calcite were only clearly observed in the intermediate stretch, which had higher tufa deposition rates than the other two. Tufa deposition rates were higher in cool (autumn+winter) than in warm (spring+summer) periods. In some low-rainfall warm periods, tufa deposition was inhibited or limited due to the low flow –mainly from groundwater inputs– and to the dryness of some river sites, which indeed favoured erosion during flooding. A decrease in yearly deposition rates from April 2006 onwards paralleled an important reduction in the river discharge. Groundwater inputs, drought periods and flood events should therefore be considered to understand fluvial tufa sedimentation in semi-arid conditions.