Observed morphodynamic changes over multiple decades were coupled with storm-driven run-up characteristics at Fire Island, New York, to explore the influence of wave processes relative to the impacts of other coastal change drivers on the near-term evolution of the barrier island. Historical topography was generated from digital stereo-photogrammetry and compared with more recent lidar surveys to quantify near-term (decadal) morphodynamic changes to the beach and primary dune system between the years 1969, 1999, and 2009. Notably increased profile volumes were observed along the entirety of the island in 1999, and likely provide the eolian source for the steady dune crest progradation observed over the relatively quiescent decade that followed. Persistent patterns of erosion and accretion over 10-, 30-, and 40-year intervals are attributable to variations in island morphology, human activity, and variations in offshore bathymetry and island orientation that influence the wave energy reaching the coast. Areas of documented long-term historical inlet formation and extensive bayside marsh development show substantial landward translation of the dune–beach profile over the near-term period of this study. Correlations among areas predicted to overwash, observed elevation changes of the dune crestline, and observed instances of overwash in undeveloped segments of the barrier island verify that overwash locations can be accurately predicted in undeveloped segments of coast. In fact, an assessment of 2012 aerial imagery collected after Hurricane Sandy confirms that overwash occurred at the majority of near-term locations persistently predicted to overwash. In addition to the storm wave climate, factors related to variations within the geologic framework which in turn influence island orientation, offshore slope, and sediment supply impact island behavior on near-term timescales.