Surface elevation tables (SETs) estimate the vertical resilience of coastal wetlands to sea-level rise (SLR) and other stressors but are limited in their spatial coverage. Conversely, spatially integrative metrics based on remote sensing provide comprehensive spatial coverage of horizontal processes but cannot track elevation trajectory at high resolution. Here, we present a critical advance in reconciling vertical and horizontal dynamics by assessing the relationship between elevation change, relative tidal elevation (Z*), and the unvegetated-vegetated marsh ratio (UVVR) across coastal wetland complexes in the southeastern USA. We first used the UVVR to determine the representativeness of the SET site relative to varying spatial footprints across the complex and found that SET sites generally represent the tidal wetland areas in terms of vegetated cover. There is also overall coherence between positive vertical change and high vegetative cover, but we also identified sites with high vegetative cover and negative vertical change (relative to SLR). The only sites exceeding the pace of SLR have UVVR values below the previously established 0.15 threshold. Some sites are not keeping up with SLR despite having intact marsh plains; this may indicate a risk of submergence with undetectable marsh plain loss, or an imminent transition to future open-water conversion. Aggregation of Z* across the same footprint as the UVVR demonstrates consistent coherence between elevation and vegetative cover, with lower elevation sites having larger UVVR. These results indicate that the UVVR is a suitable initial screening tool: areas above the 0.15 threshold are both horizontally and vertically vulnerable. Furthermore, this comparison suggests that horizontal integrity is a prerequisite for vertical stability: a marsh can only maintain elevation if the plain is intact with minimal unvegetated area.