Coastal water quality and light attenuation can detrimentally affect coral health. This study investigated the effects of light limitation and reduced water quality on the physiological performance of the coral Acropora tenuis. Branches of individual colonies were collected in 2 m water depth at six inshore reefs at increasing distances from major river sources in the Great Barrier Reef, along a strong water quality gradient in the Burdekin and a weak gradient in the Whitsunday region. Rates of net photosynthesis, dark respiration, and light and dark calcification were determined at daily light integrals (DLI) of moderate (13.86–16.38 mol photons m−2 d−1), low (7.92–9.36 mol photons m−2 d−1) and no light (0 mol photons m−2 d−1), in both the dry season (October 2013, June 2014) and the wet season (February 2014). Along the strong but not the weak water quality gradient, rates of net photosynthesis, dark respiration and light calcification increased towards the river mouth both in the dry and the wet seasons. Additionally, a ∼50% light reduction (from moderate to low light), as often found in shallow turbid waters in the Burdekin region, reduced rates of net photosynthesis and light calcification by up to 70% and 50%. The data show the acclimation potential in A. tenuis to river derived nutrients and sediments at moderate DLI (i.e., in very shallow water). However, prolonged and frequent periods of low DLI (i.e., in deeper water, especially after high river sediment discharges) will affect the corals’ energy balance, and may represent a major factor limiting the depth distribution of these corals in turbid coastal reefs.