The launch of Sentinel-3A in February 2016 represented the beginning of a new long-term series of operational satellite radar altimeters, which will provide Delay-Doppler altimetry measurements over ice sheets for decades to come. Given the potential benefits that these satellites can offer to a range of glaciological applications, it is important to establish their capacity to monitor ice sheet elevation and elevation change. Here, we present the first analysis of Sentinel-3 Delay-Doppler altimetry over the Antarctic ice sheet, and assess the accuracy and precision of retrievals of ice sheet elevation across a range of topographic regimes. Over the low-slope regions of the ice sheet interior, we find that the instrument achieves both an accuracy and a precision of the order of 10 cm, with ∼98 % of the data validated being within 50 cm of co-located airborne measurements. Across the steeper and more complex topography of the ice sheet margin, the accuracy decreases, although analysis at two coastal sites with densely surveyed airborne campaigns shows that ∼60 %–85 % of validated data are still within 1 m of co-located airborne elevation measurements. We then explore the utility of the Sentinel-3A Delay-Doppler altimeter for mapping ice sheet elevation change. We show that with only 2 years of available data, it is possible to resolve known signals of ice dynamic imbalance and to detect evidence of subglacial lake drainage activity. Our analysis demonstrates a new, long-term source of measurements of ice sheet elevation and elevation change, and the early potential of this operational system for monitoring ice sheet imbalance for decades to come.