Land-based sediment and contaminant runoff is a major threat to coral reefs, and runoff reduction efforts would benefit from knowledge of specific runoff sources. Geochemical signatures of small drainage basins were determined in the fine fraction of soil and sediment, then used in the nearshore region of a coral reef-fringed urban embayment on southeast Oahu, Hawaii, to describe sources and dispersal of land-based runoff. The sedimentary rare earth element ratio (La/Yb)N showed a clear distinction between the two main rock types in the overall contributing area, tholeiitic and alkalic olivine basalt. Based on this geochemical signature it was apparent that the majority of terrigenous sediment on the reef flat originated from geologically old tholeiitic drainages. Sediment from one of five tholeiitic drainages had a distinct geochemical signature, and sediment with this signature was dispersed on the reef flat 2 km west and 150 m offshore of the contributing basin. Sediment and the anthropogenic metals Cd, Pb, and Zn were entrained in runoff from the most heavily urbanized region of the watershed. Although anthropogenic Cd and Zn had localized distributions close to shore, anthropogenic Pb was found associated with fine sediment on the westernmost part of the reef flat and 400 m offshore, illustrating how trade-wind-driven sediment transport can increase the scale of runoff impacts to nearshore communities. Our findings show that sediment geochemical signatures can provide insights about the source and dispersal of land-based runoff in shallow coastal environments. The application of such knowledge to watershed management and habitat remediation efforts can aid in the protection and restoration of runoff-impacted coastal ecosystems worldwide.