A dome-building eruption at Mount Hood, Oregon, starting in A.D. 1781 and lasting until ca. 1793, produced dome-collapse lithic pyroclastic flows that triggered lahars and intermittently fed 10⁸ m³ of coarse volcaniclastic sediment to sediment reservoirs in headwater canyons of the Sandy River. Mobilization of dominantly sandy sediment from these reservoirs by lahars and seasonal floods initiated downstream migration of a sediment wave that resulted in a profound cycle of aggradation and degradation in the lowermost reach of the river (depositional reach), 61-87 km from the source. Stratigraphic and sedimentologic relations in the alluvial fill, together with dendrochronologic dating of degradation terraces, demonstrate that (1) channel aggradation in response to sediment loading in the headwater canyons raised the river bed in this reach at least 23 m in a decade or less; (2) the transition from aggradation to degradation in the upper part of this reach roughly coincided with the end of the dome-building eruption; (3) fluvial sediment transport and deposition, augmented by one lahar, achieved a minimum average aggradation rate of ~2 m/yr; (4) the degradation phase of the cycle was more prolonged than the aggradation phase, requiring more than half a century for the river to reach its present bed elevation; and (5) the present longitudinal profile of the Sandy River in this reach is at least 3 m above the pre-eruption profile. The pattern and rate of channel response and recovery in the Sandy River following heavy sediment loading resemble those of other rivers similarly subjected to very large sediment inputs. The magnitude of channel aggradation in the lower Sandy River, greater than that achieved at other volcanoes following much larger eruptions, was likely enhanced by lateral confinement of the channel within a narrow incised valley. A combination of at least one lahar and winter floods from frequent moderate-magnitude rainstorms and infrequent very large storms was responsible for flushing large volumes of sediment to the depositional reach. These conditions permitted a sedimentation response in the Sandy River that approached the magnitude of channel aggradation resulting elsewhere from large explosive eruptions and high-intensity rainfall regimes, despite the fact that the Sandy River aggradation was in response to an unremarkable dome-building eruption in a climate dominated by low to moderate rainfall intensities.