This paper focuses on the hydrodynamic and suspended sediment transport processes in response to sequential reclamations over the intertidal flat, Jiangsu coast, which used to be one of the widest intertidal flats in China. Investigations into the sediment transport patterns reveal that net suspended sediment fluxes increased from 102kgm−1 on the upper intertidal flat to 103–4kgm−1 on the lower intertidal flat, per tidal cycle. This variation was caused mainly by the phases of the current velocity, suspended sediment concentration (SSC), local bed geomorphology, inundation patterns, and extreme weather conditions. The longshore component of tidal currents intensifies seaward over the intertidal flat. Extreme weather conditions (e.g. storms) and strong winds were important factors affecting the current velocity structures, the intensity of residual currents, and the SSCs. The SSCs were characterized by several peaks throughout the tidal cycle. These peaks were associated with strong currents, combined wave-current interactions and intense turbulences due to the initial flood surge. Furthermore, the suspended sediment was finer and contained more clay materials during the flood phase of the tidal cycle, than during the ebb. Fine particles were transported within the upper water column by landward residual currents, but coarse particles were transported within the lower water column by seaward residual currents. Overall, residual currents were apt to transport fine-grained sediment landward and coarse-grained sediment seaward. This pattern indicates that the suspended sediment fluxes are highly variable in the water column, even for very shallow tidal environments. The cross-shore component accounted only for a small percentage of the total sediment flux. However, this part of sediment supply dominated accretion over the intertidal flat.The intertidal flat has become narrower and steeper, following sequential reclamations. A negative feedback process existed to maintain the convex profile shape, although the human activities (i.e. reclamation) could have modified the natural process. The surficial sediment tended to become finer on the mid-upper intertidal flat but coarser on the lower intertidal flat following reclamations, in response to a reduction in the tidal currents over the intertidal zone and enhancement of wave action over the lower intertidal flat. Accretion, with high rates, was maintained by landward transport of sediment. In such an accretional system with influences of reclamation, the width or slope of the intertidal flat is adjusted continuously. Before the cease of reclamation, the intertidal flat is unable to achieve an equilibrium shape.