Interactions between scleractinian corals and benthic algae can be an important process structuring reef communities, yet interaction dynamics are not fixed and may be influenced by abiotic factors such as sedimentation, a process often underlying reef degradation. However, rates of sedimentation and the effects of trapped sediments may be influenced by water flow. The first goal of this study was to quantify gradients in sedimentation and flow along fringing and back reefs of the north shore of Moorea, French Polynesia, and determine whether such gradients correlate with changes in the frequency and outcomes of massive Porites -algal turf interactions. On the back reef, the frequency of Porites–algal turf interactions and the competitive success of algal turfs increased significantly with decreasing flow. Sedimentation, however, was not a significant driver of the observed patterns. Along fringing reefs, in the absence of a flow gradient, it was the gradient in sedimentation that best explained spatial variation in Porites–algal turf interaction frequencies and the competitive success of algal turfs. The second goal was to quantify the separate and combined effects of flow and sedimentation on Porites–algal turf interactions in a laboratory setting. The combined effects of low flow and sedimentation significantly increased the area of Porites tissue damaged when in contact with algal turf, while high flow attenuated the negative effects of sedimentation. Together, these results implicate flow and sedimentation as important drivers of biological interactions between massive Porites and algal turf.