The Northeast USA is experiencing severe impacts of a changing climate, including increased winter temperatures and accelerated relative sea level rise (RSLR). The sediment-poor, organic-rich nature of many Southern New England salt marshes makes them particularly vulnerable to these changes. In order to assess how marsh accretion has changed over time, we returned to Narragansett Bay, RI where salt marsh vertical accretion rates were documented almost 30 years ago. Using radionuclide tracers (210Pb and 137Cs), we observe no significant change in overall accretion rates (0.27–0.69 cm year?1) compared to historical averages (0.24–0.60 cm year?1), but we document a shift in how these marshes maintain elevation. Organic matter now plays a smaller role in contributing to vertical accretion across all study sites, declining by 22 % on average. We attribute this reduction to potentially higher decomposition rates fueled by higher water temperature. Inorganic matter also contributes less to accretion (declining by 44 % on average at marshes located more internal to the estuary), likely due to diminishing sediment supply in this region. With organic and inorganic solids accounting for less of the total accretion, several of the marshes are experiencing symptoms of swelling, with water and porespace contributing more towards accretion compared to historical values. Accretion rates (0.27–0.45 cm year?1) at these organic-rich (>40 % sediment organic matter) marshes are predominantly lower than the current (30 years) rate of RSLR (0.41?±?0.07 cm year?1). These results, combined with the increased rate of RSLR and the hardened shorelines inhibiting landward migration, call into question the long-term survivability of these marshes.