Effective hydraulic turbine design prevents sediment and cavitation erosion from impacting the performance and reliability of the machine. Using computational fluid dynamics (CFD) techniques, this study investigated the performance characteristics of sediment and cavitation erosion on a hydraulic Francis turbine by ANSYS-CFX software. For the erosion rate calculation, the particle trajectory Tabakoff–Grant erosion model was used. To predict the cavitation characteristics, the study’s source term for interphase mass transfer was the Rayleigh–Plesset cavitation model. The experimental data acquired by this study were used to validate the existing evaluations of the Francis turbine. Hydraulic results revealed that the maximum difference was only 0.958% compared with the CFD data, and 0.547% compared with the experiment (Korea Institute of Machinery and Materials (KIMM)). The turbine blade region was affected by the erosion rate at the trailing edge because of their high velocity. Furthermore, in the cavitation–erosion simulation, it was observed that abrasion propagation began from the pressure side of the leading edge and continued along to the trailing edge of the runner. Additionally, as sediment flow rates grew within the area of the attached cavitation, they increased from the trailing edge at the suction side, and efficiency was reduced. Cavitation–sand erosion results then revealed a higher erosion rate than of those of the sand erosion condition.