This paper summarizes discussion among the 7 authors who served on an expert panel at the Third Battelle International Conference on Remediation of Contaminated Sediments held in New Orleans, Louisiana, USA, in January 2005. In this article, the authors review how sediment management decisions are currently made and address the question of how management decisions should be made in the future. It is arguably the case that sediment remediation presents greater challenges and more complexity than traditional land-based clean-ups. Although understanding of these challenges and complexities has grown over the last 25 y, there has been, until recently, relatively little innovation in the approaches used to manage the environmental risks posed by contaminated sediments. New methods that facilitate a more rigorous analysis of the multiple criteria considered in decision making have been developed. These methods, collectively known as multicriteria decision analysis (MCDA), coupled with the use of comparative-risk assessment and cost/benefit analysis, are proposed as an effective, efficient, and credible foundation for evaluating remedy alternatives at contaminated sediment sites.