Suspended sediment is a critical water quality parameter and an indicator of geomorphic processes, but suspended sediment dynamics in urban streams may not conform to the first-flush model widely used for other pollutants. We analyzed discharge and turbidity data for 367 events from three urban watersheds (impervious cover 16−45%) in Cleveland, Ohio (USA). Less intensely urbanized watersheds exhibit higher turbidity compared to that of the most highly urbanized watershed. Proportionally, more counterclockwise hysteresis is observed in the two less urbanized watersheds, and more clockwise hysteresis occurs in the highly urbanized watershed. However, hysteresis patterns are driven by different mechanisms in each watershed, and geomorphic analysis was critical to identifying the underlying mechanisms. In the least urbanized watershed, spatial rainfall variability controls sediment hysteresis. In the intermediate watershed, the erosion of upstream weathered shale banks during dry periods plays a significant role in the sediment supply and shaping hysteresis. In the most urbanized watershed, high eroding banks in downstream reaches lead to more frequent clockwise hysteresis. Overall, we suggest that as the impervious surfaces increase, the availability of instream sediments (bed and banks) plays an increased role in suspended sediment dynamics, and geomorphology remains essential for guiding management decisions.