We report stratigraphic evidence of land-level change and tsunami inundation along the Alaska-Aleutian megathrust during prehistoric and historical earthquakes west of Kodiak Island. On Sitkinak Island, cores and tidal outcrops fringing a lagoon reveal five sharp lithologic contacts that record coseismic land-level change. Radiocarbon dates, 137Cs profiles, CT scans, and microfossil assemblages are consistent with rapid uplift ca. 290-0, 520-300, and 1050-790 cal yr BP, and subsidence in AD 1964 and ca. 640-510 cal yr BP. Radiocarbon, 137Cs, and 210Pb ages bracketing a sand bed traced 1.5 km inland and evidence for sudden uplift are consistent with Russian accounts of an earthquake and tsunami in AD 1788. The mixed uplift and subsidence record suggests that Sitkinak Island sits above a non-persistent boundary near the southwestern limit of the AD 1964 Mw 9.2 megathrust rupture.