Tidal wetlands provide critically important ecosystem services such as storm surge and flood attenuation, pollution retention and transformation, and carbon sequestration. The ability of tidal wetlands to maintain surface elevation under accelerated sea level rise is critical for their persistence. Saltwater intrusion can further threaten tidal freshwater marshes by decreasing primary production and organic matter accumulation as well as cause shifts in microbial pathways, leading to increases in organic matter decomposition and an overall decrease in marsh elevation. The objectives of this research were to examine accretion dynamics across the estuarine gradient of the Nanticoke River, a major tributary of the Chesapeake Bay, and determine the relative contribution of organic and inorganic matter to accretion in the marshes; determine the accumulation rates of C, N, and P across the estuarine gradient; and examine the effects of sulfate intrusion on biogeochemical transformations and marsh surface elevation in tidal freshwater marsh soil. Results of the collective studies suggest that the mechanisms controlling accretion dynamics and nutrient accumulation are complex and are likely driven by site-specific factors rather than estuary-wide factors. Accretion rates and nutrient accumulation rates were highly variable across the estuarine gradient, but were largely dependent on both organic matter accumulation and inorganic sedimentation. Only 8 out of the 15 subsites had accretion rates higher than relative sea level rise for the area, with the lowest rates of accretion found in the oligohaline marshes. Organic matter accumulation is especially important in marshes with low mineral sediment supply, particularly mid-estuarine oligohaline marshes, but may not be enough to help keep these marshes above relative sea level. The tidal marshes along the Nanticoke River removed approximately 15% and 9% of the total N and P load entering the system, but their ability to continue to remove nutrients may be compromised due to rising sea levels. Shifts in microbial pathways and increases in organic matter decomposition due to saltwater intrusion further threaten the ability of these marshes to keep pace with sea level rise, potentially resulting in the loss of an extremely valuable ecosystem.