Anastomosing rivers were historically common around the world before extensive agricultural and industrial development in river valleys. Few lowland anastomosing rivers remain in temperate zones, and the protection of these river-floodplain systems is an international conservation priority. However, the mechanisms that drive the creation and maintenance of multiple channels, i.e. anabranches, are not well understood, particularly for lowland rivers, making it challenging to identify effective management strategies. This study uses a novel multi-scale, process-based hydro-geomorphological approach to investigate the natural and anthropogenic controls on anastomosis in lowland river reaches. Using a wide range of data (hydrologic, cartographic, remote-sensing, historical), the study (i) quantifies changes in the planform of the River Narew, Poland over the last 100 years, (ii) documents changes in the natural and anthropogenic factors that could be driving the geomorphic change, and (iii) develops a conceptual model of the controls of anastomosis.