The Pearl River Estuary Area was selected for this study. For the past 40 years, it has been one of the most complex coasts in China, yet few studies have analyzed the complexity and variations of the area’s different coastlines. In this investigation, the coastlines of the Pearl River Estuary Area were extracted from multi-temporal Landsat remote sensing data from 1978, 1988, 1997, 2008, and 2018. The coastline of this area was classified into mainland, island, and estuarine. To obtain more detailed results of the mainland and island, we regarded this area as the main body, rezoned into different parts. The box-counting dimension was applied to compute the bidimensional (2D) fractal dimension. Coastline length and the fractal dimension of different types of coastline and different parts of the main body were calculated and compared. The fractal dimension of the Pearl River Estuary Area was found to have increased significantly, from 1.228 to 1.263, and coastline length also increased during the study period. The island and mainland showed the most complex coastlines, while estuaries showed the least complexity during the past forty years. A positive correlation was found between length and 2D-fractal dimension in some parts of the study area. Land reclamation had the strongest influence on fractal dimension variations.