Hurricane Sandy was one of the most destructive hurricanes in US history, making landfall on the New Jersey coast on Oct 30, 2012. Storm impacts included several barrier island breaches, massive coastal erosion, and flooding. While changes to the subaerial landscape are relatively easily observed, storm-induced changes to the adjacent shoreface and inner continental shelf are more difficult to evaluate. These regions provide a framework for the coastal zone, are important for navigation, aggregate resources, marine ecosystems, and coastal evolution. Here we provide unprecedented perspective regarding regional inner continental shelf sediment dynamics based on both observations and numerical modeling over time scales associated with these types of large storm events. Oceanographic conditions and seafloor morphologic changes are evaluated using both a coupled atmospheric-ocean-wave-sediment numerical modeling system and observation analysis from a series of geologic surveys and oceanographic instrument deployments focused on a region offshore of Fire Island, NY. The geologic investigations conducted in 2011 and 2014 revealed lateral movement of sedimentary structures of distances up to 450 m and in water depths up to 30 m, and vertical changes in sediment thickness greater than 1 m in some locations. The modeling investigations utilize a system with grid refinement designed to simulate oceanographic conditions with progressively increasing resolutions for the entire US East Coast (5-km grid), the New York Bight (700-m grid), and offshore of Fire Island, NY (100-m grid), allowing larger scale dynamics to drive smaller scale coastal changes. Model results in the New York Bight identify maximum storm surge of up to 3 m, surface currents on the order of 2 ms-1 along the New Jersey coast, waves up to 8 m in height, and bottom stresses exceeding 10 Pa. Flow down the Hudson Shelf Valley is shown to result in convergent sediment transport and deposition along its axis. Modeled sediment redistribution along Fire Island showed erosion across the crests of inner shelf sand ridges and sedimentation in adjacent troughs, consistent with the geologic observations.