Contemporary deposition (artificial marker horizon, 3.5 years) and long-term accumulation rates (²¹⁰Pb profiles, ~150 years) of sediment and associated carbon (C), nitrogen (N), and phosphorus (P) were measured in wetlands along the tidal Savannah and Waccamaw rivers in the southeastern USA. Four sites along each river spanned an upstream-to-downstream salinification gradient, from upriver tidal freshwater forested wetland (TFFW), through moderately and highly salt-impacted forested wetlands, to oligohaline marsh downriver. Contemporary deposition rates (sediment, C, N, and P) were greatest in oligohaline marsh and lowest in TFFW along both rivers. Greater rates of deposition in oligohaline and salt-stressed forested wetlands were associated with a shift to greater clay and metal content that is likely associated with a change from low availability of watershed-derived sediment to TFFW and to greater availability of a coastal sediment source to oligohaline wetlands. Long-term accumulation rates along the Waccamaw River had the opposite spatial pattern compared to contemporary deposition, with greater rates in TFFW that declined to oligohaline marsh. Long-term sediment and elemental mass accumulation rates also were 3–9× lower than contemporary deposition rates. In comparison to other studies, sediment and associated nutrient accumulation in TFFW are lower than downriver/estuarine freshwater, oligohaline, and salt marshes, suggesting a reduced capacity for surface sedimentation (short-term) as well as shallow soil processes (long-term sedimentation) to offset sea level rise in TFFW. Nonetheless, their potentially large spatial extent suggests that TFFW have a large impact on the transport and fate of sediment and nutrients in tidal rivers and estuaries.