Large dams affect the aquatic continuum from land to ocean by accumulating particles and nutrients in their reservoirs. We examined sediment cores to quantify sediment, organic carbon (OC), nitrogen (N), and phosphorous (P) accumulation, and to examine historic changes and spatial variability in the sedimentation pattern in Lake Kariba, the largest hydropower reservoir in the Zambezi River Basin (ZRB). Sediment characteristics (concentrations of OC, N, P; delta(13)C and delta(15)N; wet bulk density) showed large variability both with sediment depth and between cores. While organic matter (OM) in river deltas was primarily allochthonous in origin, OM characteristics (delta(13)C, C:N) in lacustrine sediments suggest that autochthonous sources account for >45% of the OM that accumulates over large areas of the lake. At the same time, the relative contribution of allochthonous material within individual layers of lacustrine cores varied considerably with depth due to discrete flood deposits. The overall sediment accumulation rate in Lake Kariba is on the order of 4 x 10(6) t yr(-1), and the estimated OC accumulation of 120 x 10(3) t C yr(-1) accounts for similar to 1% of globally buried OC in reservoirs. In addition, mass balance calculations revealed that approximately 70% and 90% of incoming total N and P, respectively, are eliminated from the water column by sedimentation (N, P) and denitrification (N). Since Lake Kariba attenuates flow from similar to 50% of the ZRB, these OC, N, and P removals represent a drastic reduction in nutrient loadings to downstream riparian ecosystems and to the coastal Indian Ocean.