Blois is an urban centre created by the Romans during the first half of the 1st century AD on both banks of the middle Loire River, expanding up to the present. The city lay in part above a large alluvial plain, shaped by the fluvial activity during the Late Pleistocene and the Holocene. Within this area, series of human occupations have been documented since the Mesolithic. During the last three decades, the development of archaeological monitoring enabled the acquisition, in the urban and peripheral areas of the city, of a large dataset of sedimentary information, whose chronology ranges from prehistoric to modern times. In correlation with their context, the compilation of these multidisciplinary data (archaeological, geological, geotechnical, geophysical and topographical surveys, 14C and OSL dates, historical sources) allows scholars to better understand the relationships between the transformations of the river and human occupation by societies in the long term, before and during the city’s development. The example of the city of Blois underlines the potential of geoarchaeology in an urban fluvial environment, (i) to better understand the alluvial dynamics of a large river over long periods, (ii) to identify the factors underlying this evolution, (iii) to reconstruct the physical context of diachronic human occupation and reciprocally (iv) to highlight some impacts of human occupation on fluvial dynamics. In this portion of the middle Loire River, the evolution of the fluvial system during the Holocene was tripartite. The study shows how geoarchaeology in an urban fluvial environment plays a role in reading past evolutions, with future trends in mind.