The research objective is to investigate the variations of sediment transport in outer Changjiang Estuary and adjacent Hangzhou Bay, induced by the decline of Changjiang River sediment discharge and massive land reclamation in the last three decades. A synchronous hydrographic survey was conducted along two transects (at the bay-mouth and outer Changjiang Estuary, respectively) during the spring-neap tides of January and July 2014. The results show that the suspended sediment grain size, current velocity, suspended sediment concentration (SSC), and the water and sediment fluxes varied with the tidal cycles. Quantitative correlations with the tidal range were found for SSC and fluxes. These data have been compared with those at the same hydrographic stations in the summer and winter of the early 1980s. Along the outer Changjiang Estuary transect, the SSCs and sediment fluxes decreased in the winter, but no apparent changes occurred in the summer. The SSCs in the northern Hangzhou Bay decreased in both summer and winter, while the southern bay mouth has evolved from a low SSC region to a high SSC region. The findings clarify that the SSC and sediment flux changes in this area have only an indirect connection to the dramatic riverine sediment decline, because the sediment resuspension by the strong tidal currents provided a major source. At the present stage, the impact of the riverine sediment decline is insignificant for the SSC variation off the Changjiang River mouth. Finally, a sediment flux model is proposed to explain and predict the morphological evolution trends.