Sediment-water distribution coefficients (K d s) were obtained in estuarine areas of four A-class rivers in Japan. The total concentrations of stable elements and naturally occurring radionuclide (i.e., Na, Mg, K, Ca, V, Mn, Fe, Co, Ni, Cu, Rb, Sr, Y, Mo, Cd, La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu, Pb, and U) in the estuarine water at each sampling point and in the corresponding sediment sample were measured. K d s of most of the elements varied within one order of magnitude regarding their differences between minimum and maximum values of each element at all the stations. However, a wide variation of K d s of Mn, Fe, Co, Cu, Rb, and La was observed. In addition, geometric means (GMs) of observed K d s were compared with the recommended values in the IAEA Technical Report Series 422 (TRS-422). The results showed that GMs of K d s for most of the elements agreed well with the recommended values, but GMs of K d s for Mn, Fe, and Cd were more than 10 times lower than the recommended values. The obtained K d values could be important to investigate the behavior, transport, and fate of artificial radionuclide and to assess the radiological doses in estuarine areas.