River systems evolve in response to the construction of dams and artificial reservoirs, offering the possibility to investigate the short-term effects of base level oscillations on fluvial architecture. A major effort has been dedicated to the understanding of river response downstream of large dams, where deep channel incisions occur in response to the removal of sediment that is sequestered in the upstream reservoir. Integrating field observations and numerical-modeling results, this work quantifies the sedimentary and morphological changes of the Po River (Italy) upstream of the Isola Serafini dam to investigate the impact of dam-induced backwater on river morphodynamics. The construction of a reservoir generates a new base level that forces an upstream shift of alluvial lithofacies and a change in the planform geometry of the river. The lateral migration rate of the channel is up to 45 m/yr upstream of the influence of backwater flow and ca. 10 m/yr at the transition from normal to backwater flow conditions (30 km from the dam). Within this reach, a reduction of the bed shear stress promotes deposition of coarse-grained sediment and the emergence of the gravel–sand transition of the river. The lateral migration of the channel continuously decreases over time, and rates < 5 m/yr can be observed in the reservoir backwater zone. This trend is accompanied by the drowning of channel bars, the reduction of river competence, and an increase in bedform spacing. Oscillatory backwater and drawdown surface water profiles can be observed closer to the dam, which are associated with varying low-discharge and high-discharge events, respectively. While low-flow conditions, persisting for much of the year, allow the deposition of fine-grained sediment, high-discharge events promote not only the resuspension and transport of fine material but also the progressive erosion of channel bars and the overall deepening of the thalweg. This study provides a clear picture of the river evolution in response to the construction of a hydropower dam that may be of help in predicting how other fluvial systems will respond to future human interventions. Moreover, the result of how changes in base level and oscillations in water surface profile (backwater and drawdown) control river hydro-morphodynamics and sediment transport may provide new insights when reconstructing ancient fluvial and deltaic sequences.