Intra-wave sediment suspension is examined using high-resolution field measurements and numerical hydrodynamic and sediment models within 120 mm of a plane seabed under natural asymmetric waves. The detailed measurements of suspended sediment concentration (at 5 mm vertical resolution and at 4 Hz) showed two or three entrainment bursts around peak flow under the wave crest and another at flow reversal during the decelerating phase. At flow reversal, the mixing length was found to be approximately double the value attained at peak flow under the crest. To examine the cause of multiple suspension peaks and increased diffusion at flow reversal, a numerical “side-view” hydrodynamic model was developed to reproduce near-bed wave-induced orbital currents. Predicted currents at the bed and above the wave boundary layer were oppositely directed around flow reversal and this effect became more pronounced with increasing wave asymmetry. When the predicted orbital currents and an enhanced eddy diffusivity during periods of oppositely directed flows were applied in a Lagrangian numerical sediment transport model, unprecedented and extremely close predictions of the measured instantaneous concentrations were obtained. The numerical models were simplified to incorporate only the essential parameters and, by simulating at short time scales, empirical time-averaged parameterisations were not required. Key factors in the sediment model were fall velocities of the full grain size distribution, diffusion, separation of entrainment from settlement, and non-constant, but vertically uniform, eddy diffusivity. Over the plane bed, sediment convection by wave orbital vertical currents was found to have no significant influence on the results.