Sediment represents an important compartment in surface waters. It constitutes a habitat or spawning site for many organisms and is an essential trophic resource for higher level organisms. It can be impacted by anthropogenic activities, particularly through urban wet-weather discharges like stormwater and combined sewer overflows. An approach was presented for assessing the risks caused by urban wet-weather discharges to the sediment compartment based on total suspended solids (TSS). TSS is routinely measured in field surveys and can be considered as a tracer for urban wet-weather contamination. Three assessment endpoints linked with TSS were proposed: a) siltation of the riverbed, b) oxygen demand due to organic matter degradation and c) accumulation of ecotoxic contaminants on the riverbed (heavy metals, PAHs). These criteria were translated in terms of the maximal TSS accumulation load and exposure time (percentage of time exceeding the accumulation criteria) to account for sediment accumulation dynamics and resuspension in streams impacted by urban wet-weather discharges. These assessment endpoints were implemented in a stochastic model that calculates TSS behavior in receiving waters and allows therefore an assessment of potential impacts. The approach was applied to three Swiss case studies. For each, good agreement was found between the risk predictions and the field measurements confirming the reliability of the approach.