Coastal sediments play a fundamental role in processing anthropogenic trace metal inputs. Previous studies have shown that terrestrial organic matter (OM) is a significant vector for trace metal transport across the land-to-sea continuum, but little is known about the fate of land-derived metal-OM complexes in coastal sediments. Here, we use a comprehensive set of sediment pore water and solid-phase analyses to investigate how variations in terrestrial OM delivery since the 1950s have influenced trace metal accumulation and diagenesis in a human-impacted boreal estuary in the northern Baltic Sea. A key feature of our dataset is a strong correlation between terrestrial OM deposition and accumulation of metal-OM complexes in the sediments. Based on this strong coupling, we infer that the riverine input of terrestrial metal-OM complexes from the hinterland, followed by flocculation-induced settling in the estuary, effectively modulates sedimentary trace metal sequestration. While part of the trace metal pool associated with these complexes is efficiently recycled in the surface sediments during diagenesis, a substantial fraction is permanently buried as refractory metal-OM complexes or through incorporation into insoluble sulfides, thereby escaping further biological processing. These findings suggest that terrestrial OM input could play a more pivotal role in trace metal processing in coastal environments than hitherto acknowledged.