[Objective] Land use change is a visual manifestation of human activities intervening in topographic and geomorphic changes. The structural composition and spatial configuration of land use can be described through analyzing landscape index from the perspective of landscape ecology. In the past half century, under the influence of climate change and human activities, the water and sediment has been sharply reduced. The study of water and sediment changes in small and medium-sized rivers under the influence of human activities can provide scientific support for soil and water conservation and waterway water and sediment management in the watersheds. [Methods] Using the landscape index, water-sediment mutation test and other methods, the paper analyzes the influence of landscape patterns on water and sediment changes based on the data of water & sediment data and land use of Nanliu River and Qinjiang River Basins in the past 60 years. [Results] The results show that: (1) the runoff and sediment transport in the Nanliu River and Qinjiang River Basin show a gradual downward trend. The decreasing trend of sediment transport was more obvious than that of runoff, and the sudden change points of both runoff and sediment transport occurred in the 00s of the 21th century. (2) The proportion of forest land in Qinjiang River basin increased from 38% in 1990 to 41.6% in 2020, and the transfer area of cultivated land to forest land in Nanliujiang River gradually increased. The policy of returning farmland to forests has been effective, and the water-sediment change also shows a trend of gradual reduction. (3) The water-sediment changes in the two watersheds were negatively correlated with the degree of landscape fragmentation and positively correlated with the degree of patch aggregation. [Conclusion] In general, the land use change within the Nanliu River and Qinjiang River Basins remains stable, and the water-sediment change is more obviously affected by the land use change, so the relevant departments should strengthen the protection and management of eco-lands. In order to prevent soil erosion, excessive interference of landscape pattern by human activities should be avoided and landscape spatial configuration should be rationally planned.