The 2018 Hokkaido Eastern Iburi earthquake and its landslides threaten the safety and stability of the Atsuma River basin. This study investigates land use and land cover (LULC) change by analyzing the 2015 and 2020 LULC maps of the basin, and its impact on runoff and sediment transport in the basin by using the soil and water assessment tool (SWAT) model to accurately simulate the runoff and sediment transport process. This study finds that the earthquake and landslide transformed nearly 10% of the forest into bare land in the basin. The simulation results showed that the runoff, which was simulated based on the 2020 LULC data, was slightly higher than that based on the 2015 LULC data, and the sediment transport after the earthquake is significantly higher than before. The rate of sediment transportation after the earthquake, adjusted according to the runoff, was about 3.42 times more than before. This shows that as the forest land decreased, the bare land increased. Conversely, the runoff increased slightly, whereas the sediment transport rate increased significantly in the Atsuma River basin after the earthquake. In future, active governance activities performed by humans can reduce the amount of sediment transport in the basin.