Over the coming century, climate change and sea-level rise are predicted to cause widespread change to coastal wetlands. Estuarine vegetated wetlands can adapt to sea-level rise through both vertical development (i.e., biophysical feedbacks and sedimentation) and upslope/horizontal migration. Quantifying changes to estuarine vegetated wetlands over time can help to inform current and future decisions regarding land management and resource stewardship. In this study, we show how coastal land cover maps readily available in the US can be used to assess and understand estuarine vegetated wetland changes. This assessment involves two steps: (1) identifying the net gain/loss of estuarine vegetated wetlands and (2) determining which land cover types contribute to the net gain/loss. From this information, we developed estuarine vegetated wetland change scenarios that evaluate whether estuarine vegetated wetland gain kept up with loss and whether the contribution was from: (1) estuarine vegetated wetland migration or tidal restoration; (2) land building (i.e., development); or (3) both. We assessed changes from 1996 to 2016 for: (1) the conterminous US; (2) each major US coastline; and (3) focal estuaries with the most change per coast. We found that the change scenario (1, 2, or 3) varied across coastlines. Moving forward, national coastal land cover programs can be informed by utilizing methodologies that leverage contemporary information for delineating the estuarine zone from upslope/adjacent wetlands. We highlight approaches that could be used to address this challenge and provide complementary information related to wetland condition changes.