To control and improve the phenomena of rocky desertification and soil erosion in karst landform areas, which are caused by a series of human factors that include social and economic development and human activities, China has successively introduced many policies, resulting in spatial and temporal changes in the landscape pattern of the southern karst area. In this study, land use transfer intensity maps, the grid method, the sample line method, the semivariogram method, and the Spearman analysis method are used to explore the spatial and temporal evolutions in surface runoff as responses to landscape pattern and policy factors in karst landform area. Therefore, this study provides theoretical and policy support for improving the regional landscape structure, optimizing the landscape layout, introducing regional policies, reducing surface runoff, and alleviating soil erosion. The results show that the best scale for the study of landscape patterns in the southern karst area is 3000 m. Forests are the land type that make up the highest proportion in the southern karst area, and they have the strongest interception capacity for surface runoff. The spatial and temporal distributions of the surface runoff are significantly different, and urban expansion has led to an increase in impervious runoff year over year. Runoff is positively correlated with the Shannon diversity index (SHDI), patch density (PD), and landscape shape index (LSI). The stronger the landscape heterogeneity, the more runoff. DIVISION is positively correlated with forest runoff and negatively correlated with other land types. The higher is the degree of aggregation of impervious patches, the higher the regional runoff rate. The more dispersed the forest patches are, the smaller the area proportion, and the greater the runoff. In addition, policy factors have a significant impact on surface runoff.