The risks to human populations in coastal areas are changing due to climate and socio-economic changes, and these trends are predicted to accelerate during the twenty-first century. To understand these changing risks, and the resulting choices and pathways to successful management and adaptation, broad-scale integrated assessment is essential. Due to their complexity the two risks of flooding and erosion are usually managed independently, yet frequently they are interconnected by longshore exchange of sediments and the resulting broad scale morphological system behaviour. In order to generate new insights into the effects of climate change and coastal management practises on coastal erosion and flood risk, we present an integrated assessment of 72 km of shoreline over the twenty-first century on the East Anglian coast of England which is a site of significant controversy about how to manage coastal flood and erosion risks over the twenty-first century. A coupled system of hydrodynamic, morphological, reliability and socio-economic models has been developed for the analysis, implemented under scenarios of coastal management, climate and socio-economic change. The study is unique in coastal management terms because of the large spatial scale and extended temporal scale over which the analysis is quantified. This study for the first time quantifies what has for some years been argued qualitatively: the role of sediments released from cliff erosion in protecting neighbouring low-lying land from flooding. The losses and benefits are expressed using the common currency of economic risk. The analysis demonstrates that over the twenty-first century, flood risk in the study area is expected to be an order of magnitude greater than erosion risk. Climate and socio-economic change and coastal management policy have a significant influence on flood risk. This study demonstrates that the choices concerning coastal management are profound, and there are clear tradeoffs between erosion and flood impacts.