Rivers support indispensable ecological functions and human health and infrastructure. Yet limited river sampling hinders our understanding of consequential changes to river systems. Satellite-based estimates of suspended sediment concentration and flux for 414 major rivers reveal widespread global change that is directly attributable to human activity in the past half-century. Sediment trapping by dams in the global hydrologic north has contributed to global sediment flux declines to 49% of pre-dam conditions. Recently, intensive land-use change in the global hydrologic south has increased erosion, with river suspended sediment concentration on average 41 ± 7% greater than in the 1980s. This north-south divergence has rapidly reconfigured global patterns in sediment flux to the oceans, with the dominant sources of suspended sediment shifting from Asia to South America.