Elevated fine sediment input from terrestrial and aquatic sources as a result of anthropogenic activity is widely recognized to impact negatively on aquatic ecosystems. In rivers, freshwater fish are exposed to a range of impacts resulting from fine sediment pressures. To date, research on the effects of fine sediments on fish has been concentrated within relatively few families, notably the salmonidae. This paper reviews the literature describing indirect and direct impacts of fine sediment on freshwater fish as a contribution towards enhancing the understanding of the impacts of anthropogenic activities on freshwater ecosystems. We identify the causal mechanisms that underpin the observed negative response exhibited by fish populations to enhanced fine sediment loads, and the variability across different fish species. Copyright © 2011 John Wiley & Sons, Ltd.