Since the opening of the Sidi Salem dam on the watercourse of the Medjerda, in 1981, an alarming narrowing of the riverbed in the lower valley has been observed. This geo-morphological change is attributed to different factors ranking from the reduction in the discharge flows, which used to clean out the riverbed to the periodic releases of turbid water undertaken to remove the silt deposition inside the reservoir, which increased the sediment deposition in the downstream channel. Other smaller hydraulic projects are also held responsible for the loss of the water velocity including a series of concrete sills meant to raise water levels, numerous cross bridges and the management of the downstream Laroussia dam regulating the discharge from the Cap Bon canal. The above anthropogenic factors, in conjunction with natural topographical conditions characterized by a generally shallow slope and a very sinuous watercourse, led to an extremely rapid aggradation of the downstream channel-bed. This paper proposes an analysis of this process and argues that the resulting reduction in channel capacity is one of the major causes of the large floods experienced in the country since 1996.