Urban coral reefs experience chronic disturbances from anthropogenic activities that result in environmental effects such as sedimentation, which can often be traced to coastal development, land reclamation, and runoff. Prolonged sedimentation can reduce light availability for autotrophic corals and physically smother coral species and trigger stress responses that impact reef health. These effects have led to notable changes and declines of coral biodiversity in Singapore, where high sedimentation rates have shifted coral composition and reduced species diversity. Here, we review how different coral species, growth forms and reef communities respond to sedimentation. We also examine coral–sediment interactions in Singapore by surveying ten contemporary reef sites to quantify patterns of sediment accumulation on scleractinian corals. Results reveal that certain coral species and growth forms—particularly the laminar, massive and encrusting forms—accumulate higher sediment loads. Understanding sedimentation patterns across Singapore’s reefs can enhance our responses to ongoing reef degradation and inform future conservation efforts. The complex interactions between physical sedimentation, turbidity and light attenuation and their combined impacts on coral health remain unclear. Future research should establish sedimentation and turbidity thresholds that cause significant stress to Singapore’s coral communities, providing essential data for informed reef management practices.