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The interplay between erosion and deposition are fundamental characteristics of river basins. These processes result in the delivery, retention and conveyance of sediment through river systems. Although the delivery of sediment to rivers is a natural phenomenon, in recent years there has been increasing concern about the enhancement of sediment loadings as a result of anthropogenic activities. The presence of macrophytes in river channels tends to increase the retention of fine sediment leading to changes in bed composition. However, a complex relationship exists between macrophytes and fine sediment: macrophytes affect the conveyance of fine sediment and are, in turn, affected by the sediment loading. This review deals with these two reciprocal effects and, in particular, summarizes the available evidence base on the impact of fine sediment on macrophytes. Increased inputs of fine sediment appear to have both direct and indirect impacts on the macrophyte community, altering light availability, and the structure and quality of the river bed. The nature of these impacts depends largely on the rate of deposition and the nature of the material deposited. Changes in macrophyte community composition may ensue where the depositing material is more nutrient rich than the natural river bed. Many of the changes in macrophyte flora that occur with increased fine sediment inputs are likely to closely parallel those that occur with increased dissolved nutrient availability. If attempts to manage nutrient inputs to rivers are to achieve their goals, it is critical that fine sediment-associated nutrient dynamics and transfers are considered. Copyright © 2011 John Wiley & Sons, Ltd.