By collecting surface sediment samples from 158 stations in the near-shore waters of eastern Guangdong, grain size analysis and grain size parameter calculations were performed to explore the characteristics and migration trends of surface sediments in the area. The analysis of the grain size results showed that the surface sediments in the nearshore waters of east Guangdong could be classified into nine sediment types, mainly including seven types of gravel sand ((g)S), gravel muddy sand ((g)mS), gravelly mud ((g)M), sand (S), silty sand (zS), sandy silt (sZ) and silt (Z). The relative percentages of gravel, sand, silt and mud were 0.7%, 40.56%, 46.7% and 12.04%, respectively. The average grain size varied from −2φ to 8φ, with an average of 4.94φ. The selection coefficient ranged from 0.44 to 3.78, with an average value of 1.8. The skewness distribution ranged from −0.34 to 0.67, with an average value of 0.07. By extracting and analyzing the spatial distribution information of grain size in the study area, using the Gao–Collins migration trend analysis method and incorporating dynamic factors such as tidal currents and waves, the transport direction and trend of surface sediments in the study area could be analyzed and inferred. The results show that the surface sediment migration trend was significant, migration on the north side of Nan’ao Island was in an east-to-west direction, and the sediment of Yifeng River was mainly deposited to the sand spout at the mouth of Lianyang River. After southward transport from the Houjiang waterway, the migration was mainly southeastward and the trend was quite significant until the 20 m isobath, where the trend gradually decreased. The sediments of the Rongjiang River were mainly deposited outside the mouth of Niutian Yang and Rongjiang River, and the surface sediments of Guang’ao Bay and Haimen Bay migrated in the northwest–southeast direction. After the 30 m isobath, the southeast corner of the study area migrated in the southeast–south direction. This sediment transport pattern revealed by the grain size migration trend is in good agreement with the physical and hydrodynamic conditions of the study area and provides an important reference for decisions regarding port dredging and waterway management in the area.