A cumulative impacts analysis of 38 tidal inlets located between Cape Henry at the mouth of Chesapeake Bay and Cape Romain in South Carolina indicates that the majority of the inlets are artificially manipulated. Nine of the inlets have hard stabilization structures such as jetties, terminal groins or revetments on at least one shoulder (Ruddee Inlet in VA; Oregon , Beaufort, Mason and Masonboro Inlets in NC; and Little River, Hog, Murrell's, and Midway Inlets in SC). Two inlets (Carolina Beach and Drum Inlets, NC) have been artificially created and two (Tubbs and Mason Inlets, NC) have been relocated to protect adjacent development. At least 5 of the inlets have been artificially closed (South Masonboro, Buxton, Mason, and Moore's Inlets in NC and a hurricane breach north of Pawley's Inlet, SC) and 4 have closed naturally (Mad, New, Old Topsail and Old Drum Inlets, NC). Hurricanes have opened 12 new inlets in this region during the period of 1990-2000; some of these have closed naturally and others have been manually closed. The tidal channels of approximately half of the inlets are dredged and at least 18 have disposal of dredge material on beaches adjacent to the inlets. Inlet sand bodies provide or are targeted as a source for beach nourishment material at one-fourth of the inlets. Fewer than one-quarter of the inlets currently open have been left in a natural, undisturbed state.