The long-term effects of sediment exposure on aquatic organisms are poorly understood, yet it is critical for determining threshold effects and exposure limits to mitigate potential impacts with regard to population dynamics. In this paper, we present the current state of knowledge to help consolidate the breadth of information regarding total suspended solids (TSS) thresholds for aquatic species, as well as identify areas where data are lacking. More specifically, we provide the state of the science related to TSS effects on freshwater and estuarine fish including short-term (i.e., physiology and behavior) and long-term effects. Our research indicated that little attention has been given to examining long-term effects, e.g., transgenerational effects, from suspended sediments (SS) on fish populations. Understanding transgenerational effects is paramount to developing and predicting the links between fish condition, survival, populations, and communities. Survival of a local fish population to high sediment loads often translates into short-term physiological and behavioral effects; however, the ramifications of such exposure events are rarely tracked across generations. The majority of studies involving SS effects on fish have focused on exposure and mortality rates of affected fish, deposited eggs, or larvae. We developed a conceptual model that highlighted the interactions between sediment dynamics and fish populations. The model can assist in the formulation of more quantitative-based approaches for modeling these interactions. Future research efforts should focus on developing an understanding of whether environmental disturbances, e.g., dredging, may lead to epigenetic changes that may lead to cascade population effects, and if so, under what circumstances.