The impacts of a dam on the river downstream in terms of hydrology and morphology are determined by a complex mix of variables that includes the patterns of release of water through the dam and the characteristics of the downstream channel. Scour of the downstream channel is a common response because large dams cause a significant interruption to sediment continuity. Here we show that in the case of China's Three Gorges Dam on the Yangtze River the outcome is complicated, as is commonly the case in large rivers. The downstream channel and floodplain system compose an area of long-term sediment accumulation and unstable channels with seasonally contrasting erosion and deposition patterns related to the migrating seasonal monsoon rainfall zones. In achieving one of the main purposes of this dam, that of flood control in the middle and lower basins, the pattern of flows released from the dam will closely resemble those seasonal flows that are responsible for channel instability in the middle catchment, thus effectively making erosive conditions the most common during a year. There is obviously concern about the ultimate impact of sediment storage in the dam on the dynamics of the delta and adjacent coast, and we show that this depends on the trajectory and duration of the erosive responses in the middle Yangtze basin. In this particular case, the outcome is of great significance to the well being of the densely populated riparian areas of the river.