The structural framework of the northern Gulf of Mexico coastal zone is characterized by numerous growth fault systems. Neotectonic processes in coastal marshes in this region have been shown to be important drivers of relative sea-level rise as well as having significant influence on marsh accretion processes. One active growth fault has been identified at East Matagorda Peninsula, Texas. To characterize the Holocene behavior of this fault and the consequent sedimentary responses, a suite of fallout radionuclides (7Be, 137Cs, 210Pb) and radiocarbon, supplemented by sediment physical property data have been used to determine sediment mixing depths, rates of accumulation, and geochronology. Correlation of time-equivalent stratigraphic boundaries reveals a maximum total Holocene offset of ~1 meter. Determination of slip rates from these values reveals a linear trend of displacement as a function of distance along the fault trace with maximum slip occurring to the southwest and minimum slip to the northeast. Sediment accumulation rates from the downthrown station nearest to the fault trace display a dramatic increase over the last 30 years. Sediment bulk density and grain size data suggest an interaction between fault-driven geomorphic change and sedimentation where a migrating land-water interface has influenced the type of sediment accumulation here.