Suspended particulate matter (SPM) concentration and particle size distribution (PSD) were assessed in a coastal turbidity maximum area (southern North Sea) during a composite period of 37 days in January–April 2008. PSDs were measured with a LISST 100X and classified using entropy analysis in terms of subtidal alongshore flow. The PSDs during tide-dominated conditions showed distinct multimodal behaviour due to flocculation, revealing that the building blocks of flocs consist of primary particles (<3 μm) and flocculi (15 μm). Flocculi comprise clusters of clay minerals, whereas primary particles have various compositions (calcite, clays). The PSDs during storms with a NE-directed alongshore subtidal current (NE storms) are typically unimodal and characterised by mainly granular material (silt, sand) resuspended from the seabed. During storms with a SW-directed alongshore subtidal current (SW storms), by contrast, mainly flocculated material can be identified in the PSDs. The findings emphasise the importance of wind-induced advection, alongshore subtidal flow and highly concentrated mud suspensions (HCMSs) as regulating mechanisms of SPM concentration, as well as other SPM characteristics (cohesiveness or composition of mixed sediment particles) and size distribution in a high-turbidity area. The direction of subtidal alongshore flow during SW storm events results in an increase in cohesive SPM concentration, HCMS formation, and the armouring of sand; by contrast, there is a decrease in cohesive SPM concentration, no HCMS formation, and an increase in sand and silt in suspension during NE storms.