Lingding Bay (LDB), on the Pearl River Delta (PRD) of southern China, is a typical example of a large river mouth that is strongly affected by anthropogenic perturbations that have changed the boundary conditions of hydro- and sediment dynamic processes. An analysis of recent sedimentary patterns can shed light on the role of anthropogenic impacts on delta evolution. In this study, we collected surficial sediments from the LDB in December 2016 (dry season) and August 2017 (flood season) to analyze their grain size and organic geochemical compositions, with the aim of investigating recent depositional patterns in the bay and evaluating human impacts. The results reveal two major mud depocenters in the northeastern and southwestern parts of the bay, which are characterized by high values of grain-size end member 1 (EM1) and increased contributions of terrestrial organic carbon in the flood season. We propose that this sedimentary pattern is a manifestation of a system regime shift due to the strengthening of the fluvial function in fluvial-tide interactions and associated changes in the suspended sediment dispersal routine. We suggest that these changes are a result of recently intensified human activities, such as coastal land reclamation and sand mining. Coarsening of the surficial sediments in the LDB in the dry season and a marked increase in the terrestrial organic contribution at the mouth of the LDB indicates the redistribution of fine-grained sediments by waves and currents and increased mud export from the LDB in response to the shallowing of the bay.