We present three-dimensional simulations of sedimentation of suspended solids in inclined vessels using a Eulerian-Lagrangian model developed specifically for the study of solid-liquid mixtures. The simulation results reveal the three-dimensional vortical flow structures that follow the occurrence of flow instability and induce strong mixing between the particle-laden and clear-fluid layers. We show that the tubes exhibit significant spanwise variation due to the presence of wall boundary layers and are subsequently transformed into three-dimensional turbulent structures. The vortices and turbulence result in significant resuspension from the particle-laden layer and weaken the convective effect that enhances sedimentation. We show that for the present flow condition and particle size, particle inertia plays an important role in particle resuspension. Analysis of the release of potential energy is presented to examine the sedimentation efficiency under different flow conditions. We show that the time history for a typical case can be divided into development, convection, and deposition stages. The analysis for cases with different particle sizes shows that the faster settling associated with larger particles stabilizes the flow by reducing the interfacial shear while settling. From simulation results using various angles of inclination, we can find the optimal angle of inclination to achieve the greatest efficiency in settling enhancement. Finally, critical modeling aspects, including the importance of different forcing terms and two- or three-dimensional considerations, are discussed. (C) 2019 Elsevier B.V. All rights reserved.