Ecosystem services (ESs) in rapidly urbanizing agricultural basins are vulnerable to environmental changes. Adequately understanding the driving forces and the dynamics of ESs related to water quantity and quality can provide a basis for making sound management decisions on the development of basins. Here, we explored the impacts of future land use and climate changes on four ESs: nitrogen and phosphorous purification, water supply, and soil retention services in the Taihu Basin region of eastern China. Spatially explicit methods, a cellular automata-Markov (CA-Markov) model and the delta downscaling method were used to quantify the ESs, simulate land use changes, and project future climate changes, respectively. We built a business-as-usual land use scenario, representative concentration pathways (RCPs) scenarios for climate change, as well as a combined land use and climate change scenario to analyze the changes in the drivers and the responses of ESs. The results showed the following: (1) future land use changes would significantly enhance the nitrogen purification service while reducing the phosphorus purification service compared to other services; (2) climate change would have substantial effects on water supply and soil retention, but these impacts would vary with different RCPs scenarios during three future periods; and (3) the combined scenarios of both drivers would obviously influence all ESs and lead to a nitrogen purification service that was different from the other three services. Moreover, the policy implications of the results were discussed. The findings can help guide the creation of policies for land structure and patterns, climate change adaptation, and ecosystem-based management to promote the sustainable development of watersheds at the regional scale.