The sustainable use of water resources requires clear guidelines for the management of diffuse pollution inputs to rivers. Without informed guidelines, management decisions are unlikely to deliver cost-effective improvements in the quality of rivers as required by current water policy. Here, we review the evidence available for deriving improved guidelines on the loading of fine sediment to rivers based on the impact on macro-invertebrates. The relationship between macro-invertebrates and fine sediments is poorly defined. Studies of the impacts of fine sediment on macro-invertebrates have been undertaken at various scales, which has an influence on the range of responses displayed and the reliability of the results obtained; results obtained from investigations at smaller scales may not manifest at the scale required to manage rivers and vice versa. Many of the identified effects of increased loading of fine sediment on macro-invertebrates occur as a consequence of deposition on the river bed, yet many current management guidelines are based on suspended sediment targets. On this basis, existing water quality guidelines for sediment management are unlikely to be appropriate. Copyright © 2011 John Wiley & Sons, Ltd.