Reservoir sedimentation related problem is one of the key technical issues in the Three Gorges Project (TGP). It is related to the success of the TGP design and operation for safety and efficiency. Systematic and continuous monitoring and research have been conducted on major sedimentation related problems during the stages of demonstration, design, construction, and operation, providing significant technological support for successful completion and operation of the TGP. This article systematically elaborated on the research process and solutions to sediment problems in the TGP, and summarized the research achievements in the changes of inflow water and sediment, reservoir sedimentation, downstream scouring, and sediment optimization scheduling. The results showed that reservoir sedimentation and its impact on the TGP have not exceeded the prediction results in stage of demonstration and preliminary design, and reservoir sedimentation related problems were in a safe and controllable state. This article also proposed suggestions for future research on sediment issues based on new demands and requirements, including joint sediment scheduling of cascade reservoirs, ecological benefits of sediment changes, and improvement of sediment monitoring technology.