Sediment is one of the main factors affecting the ecological environment of rivers, and its eco-environmental effect plays an important role in maintaining the balance of water environment and aquatic biodiversity. Sediment in mountain rivers has obvious characteristics such as wide gradation, which has unique impacts on the ecological environment. In addition, the increasingly intense human activities in mountain rivers, such as the construction and operation of large-scale cascade reservoirs, lead to further complicated changes in the ecological and environmental effects of sediment. In this paper, the environmental effects of mountain river sediment in adsorption, desorption and transport and the ecological effects on aquatic microorganisms, animals, plants and the entire food web were systematically reviewed. The problems existing in relevant researches were discussed, and the research prospects were presented, in order to provide guidance for the protection of mountain rivers.