High sedimentation rates can damage coral reef ecosystems. Sedimentation rates are controlled by both sediment loads from watersheds and resuspension by waves and associated circulation patterns, but the outcomes are system specific and difficult to predict. The percent terrigenous (non-organic and non-carbonaceous) material in sediment is also often used as an indicator of watershed influence, but its dynamics are poorly understood. Sediment accumulation rates, particle size, and percent terrigenous were monitored quasi-monthly for one year (March 2014-April 2015) at nine sites in a coral reef-fringed embayment in American Samoa, where an aggregate quarry had increased sediment loads to the coast but mitigation reduced loads during the monitored period. Gross and net sediment accumulation rates were measured using sediment traps and SedPods (pods), respectively. Gross accumulation rates exceeded thresholds for impacts on coral health during at least one collection period at most sites, with more exceedances on the northern reef where water residence times and sediment availability are higher and corals show signs of sediment stress. Percent terrigenous of coarse sediment was higher in the traps and pods compared with the surrounding benthic sediment, indicating that some of the terrigenous sediment was advected through the bay without accumulating on the reef. The 95th percentile of hourly wave energy density (E₉₅) taken from a global wave model (WaveWatch 3) was the best predictor of gross accumulation rates of both total and carbonate sediment in a log-log regression at most (n = 6) sites (R² range 0.72-0.92), indicating a strong role of resuspension of benthic sediment. Gross accumulation rates of terrigenous sediment were not correlated with E₉₅ and only correlated with SSY at the site nearest the stream mouth, indicating that most terrigenous sediment was not from resuspended benthic material but rather from a consistent watershed source. Percent terrigenous decreased with increasing wave energy due to high accumulation rates of carbonates during periods of high wave energy. Detection of the impact of sediment mitigation at the quarry on sediment accumulation was complicated by low wave energy in the period following mitigation. The use of gross accumulation rates and percent terrigenous as indicators of the magnitude and sources of sediment accumulation over time needs to account for wave-induced resuspension, which can be modelled with a simple power function using inputs from a global wave model.