Management and restoration of coastal wetlands require insight into how inundation, salinity, and the availability of mineral sediment and nutrients interact to influence ecosystem functions that control sustainability. The Mississippi River Delta, which ranks among the world's largest and most productive coastal wetland complexes, has experienced extensive deterioration over the last century due, in large part, to enhanced vulnerability to relative sea-level rise and lateral erosion caused by a combination of natural processes and anthropogenic modifications of hydrology. This land loss crisis has prompted the State of Louisiana to develop a comprehensive restoration plan that includes constructing and implementing a series of large-scale sediment diversions that will reconnect sediment- and nutrient-rich Mississippi River water to adjacent bays, estuaries, and wetlands. Sediment loading through diversions is predicted to enhance the long-term sustainability of coastal wetlands; however, the additive effects of increased inundation, abrubt changes in the salinity regime, and high nutrient loads on wetland plant growth and organic matter (SOM) decomposition rates, which help regulate accretion and elevation change, is uncertain. Therefore, this review attempts to synthesize existing information to inform predictions of the interactive effects of diversions on these drivers of coastal wetland sustainability. The data suggest that sediment deposition within an optimal elevation range will increase the overall productivity of existing wetlands where prolonged flooding does not counter this effect by limiting plant growth. A reduction in salinity may increase plant productivity and cause vegetation shifts to less salt tolerant species, but seasonal swings in salinity may have unforeseen consequences. Nutrient-loading is predicted to lead to greater aboveground productivity, which, in turn, can facilitate additional sediment trapping; however, belowground productivity may decline, particularly in areas where sediment deposition is limited. In areas experiencing net deposition, nutrient-enrichment is predicted to enhance belowground growth into new sediment and contribute to positive effects on soil organic matter accumulation, accretion, and elevation change. Thus, we contend that sediment input is essential for limiting the negative effects of flooding and nutrient-enrichment on wetland processes. These conclusions are generally supported by the biophysical feedbacks occurring in existing prograding deltas of the Mississippi River Delta complex.