An evolutionary model of sedimentary environments since late Marine Isotope Stage 3 (late MIS 3, i.e., ca. 39 cal ka BP) along the middle Jiangsu coast is presented based upon a reinterpretation of core 07SR01, new correlations between adjacent published cores, and shallow seismic profiles recovered in the Xiyang tidal channel and adjacent northern sea areas. Geomorphology, sedimentology, radiocarbon dating and seismic and sequence stratigraphy are combined to confirm that environmental changes since late MIS 3 in the study area were controlled primarily by sea-level fluctuations, sediment discharge of paleo-rivers into the South Yellow Sea (SYS), and minor tectonic subsidence, all of which impacted the progression of regional geomorphic and sedimentary environments (i.e., coastal barrier island, freshwater lacustrine swamp, river floodplain, coastal marsh, tidal sand ridge, and tidal channel). This resulted in the formation of a fifth-order sequence stratigraphy, comprised of the parasequence of the late stage of the last interstadial (Para-Sq2), including the highstand and forced regressive wedge system tracts (HST and FRWST), and the parasequence of the postglacial period (Para-Sq1), including the transgressive and highstand system tracts (TST and HST). The tidal sand ridges likely began to develop during the postglacial transgression as sea-level rise covered the middle Jiangsu coast at ca. 9.0 cal ka BP. These initially submerged tidal sand ridges were constantly migrating until the southward migration of the Yellow River mouth to the northern Jiangsu coast during AD 1128 to 1855. The paleo-Xiyang tidal channel that was determined by the paleo-tidal current field and significantly different from the modern one, was in existence during the Holocene transgressive maxima and lasted until AD 1128. Following the capture of the Huaihe River in AD 1128 by the Yellow River, the paleo-Xiyang tidal channel was infilled with a large amount of river-derived sediments from AD 1128 to 1855, causing the emergence of some of the previously submerged tidal sand ridges. From AD 1855 to the present, the infilled paleo-Xiyang tidal channel has undergone scouring, resulting in its modern form. The modern Xiyang tidal channel continues to widen and deepen, due both to strong tidal current scouring and anthropogenic activities.