The magnitude and variation of the sediment loads transported by rivers are of important significance to the functioning of river system, and changes in sediment loads of rivers are driven by numerous factors. In this paper, key drivers of changes in sediment loads of rivers in China are analyzed by reviewing recent publications of studies on changes in sediment loads. It can be concluded that nearly all of the major rivers in China exhibit an apparent decline in annual sediment loads except for the Songhua River, which presents no clear tendency of changes in runoff and sediment loads. The total annual sediment loads of major rivers transported to the coasts in China decreased from 2.03 billion t/a during the period of 1955 to 1968 to 0.50 billion t/a during the period of 1997 to 2010. The primary drivers of changes in the sediment loads of rivers are dam construction, soil and water conservation measure, catchment disturbance, sand mining and climate change. Case studies for rivers in China show the following:construction of a large number of reservoirs in the Yangtze River basin is the primary driver of the reduction of the sediment load of the Yangtze River; soil and water conservation measure is one of the key drivers of the sharp decline in the sediment load of the Yellow River; the catchment disturbance explains why the reduction of the sediment load of ChiangSaen Station was much lower than that of Gajiu Station on the Lancang-Mekong River; the decreasing sediment load resulting from the growth of agricultural production may be the main driver of the sediment reduction of the Huaihe River; the decrease in the sediment load of the Pearl River was influenced by sand mining activities; and climate change in the Haihe River Basin is one of the key drivers of the great reduction of the sediment load of the Haihe River.