Sand extraction from the mid-lower Yangtze has increased rapidly since the 1980s, in contrast to a rapid decrease in sediment discharge from the Yangtze River into the sea. In-channel sand extraction poses great risks to flood protection, navigation channels and railway bridges. This paper reviews the recent history of in-channel sand extraction, discussing the present status and potential problems in legislation and management. It is concluded that the share of interests, the involvement of local criminal gangs and official corruption were the main difficulties for the ban on illegal sand extraction. It is proposed that the sites and amounts permitted for in-channel sand extraction should be re-evaluated under the new sediment budget after closure of the Three-Gorges Dam. It is necessary to explore the use of alternative materials in order to reduce the demand for natural sand while meeting the market needs for socio-economic development.