Marsh soil development and vertical accretion in Spartina patens (Aiton) Muhl.-dominated tidal marshes is largely dependent on soil organic matter accumulation from root-rhizome production and litter deposition. Yet there are few quantitative data sets on belowground production and the relationship between soil organic matter accumulation and soil elevation dynamics for this marsh type. Spartina patens marshes are subject to numerous stressors, including sea-level rise, water level manipulations (i.e., flooding and draining) by impoundments, and prescribed burning. These stressors could influence long-term marsh sustainability by their effect on root production, soil organic matter accumulation, and soil elevation dynamics. In this review, we summarize current knowledge on the interactions among vegetative production, soil organic matter accumulation and marsh elevation dynamics, or the ecogeomorphology, of Spartina patens-dominated tidal marshes. Additional studies are needed of belowground production/decomposition and soil elevation change (measured simultaneously) to better understand the links among soil organic matter accumulation, soil elevation change, and disturbance in this marsh type. From a management perspective, we need to better understand the impacts of disturbance stressors, both lethal and sub-lethal, and the interactive effect of multiple stressors on soil elevation dynamics in order to develop better management practices to safeguard marsh sustainability as sea level rises.