Abstract: Many rivers and streams of the Mid-Atlantic Region, United States (U.S.) have been altered by postcolonial floodplain sedimentation (legacy sediment) associated with numerous milldams. Little Conestoga Creek, Pennsylvania, a tributary to the Susquehanna River and the Chesapeake Bay, is one of these streams. Floodplain sedimentation rates, bank erosion rates, and channel morphology were measured annually during 2004-2007 at five sites along a 28-km length of Little Conestoga Creek with nine colonial era milldams (one dam was still in place in 2007). This study was part of a larger cooperative effort to quantify floodplain sedimentation, bank erosion, and channel morphology in a high sediment yielding region of the Chesapeake Bay watershed. Data from the five sites were used to estimate the annual volume and mass of sediment stored on the floodplain and eroded from the banks for 14 segments along the 28-km length of creek. A bank and floodplain reach based sediment budget (sediment budget) was constructed for the 28 km by summing the net volume of sediment deposited and eroded from each segment. Mean floodplain sedimentation rates for Little Conestoga Creek were variable, with erosion at one upstream site (−5 mm/year) to deposition at the other four sites (highest = 11 mm/year) despite over a meter of floodplain aggradation from postcolonial sedimentation. Mean bank erosion rates range between 29 and 163 mm/year among the five sites. Bank height increased 1 m for every 10.6 m of channel width, from upstream to downstream (R2 = 0.79, p < 0.0001) resulting in progressively lowered hydraulic connectivity between the channel and the floodplain. Floodplain sedimentation and bank erosion rates also appear to be affected by the proximity of the segments to one existing milldam, which promotes deposition upstream and scouring downstream. The floodplain and bank along the 28-km reach produced a net mean sediment loss of 5,634 Mg/year for 2004-2007, indicating that bank erosion was exceeding floodplain sedimentation. In particular, the three segments between the existing dam and the confluence with the Conestoga River (32% of the studied reach) account for 97% of the measured net sediment budget. Future research directed at understanding channel equilibria should facilitate efforts to reduce the sediment impacts of dam removal and legacy sediment.