With rapid economic development, extensive human activity has changed landscape patterns (LPs) dramatically, which has further influenced hydrological processes. However, the effects of LPs changes on hydrological processes, especially for the streamflow–sediment relationship in the subtropical monsoon climate zone, have not been reported. In our study, 10 watersheds with different sizes in the subtropical monsoon climate zone of southeastern China were chosen as the study area, and the effect of the 14 most commonly used landscape metrics (LMs) on 4 typical hydrological indices (water yields (WY), the runoff coefficient (RC), the soil erosion modulus (SEM), and the suspended sediment concentration (SSC)) were analyzed based on land use maps and hydrological data from 1990 to 2019. The results reveal that the LP characteristics within the study area have changed significantly. The number of patches and landscape shape indices were significantly positively correlated with watershed size (p < 0.01). For most watersheds, the largest patch index was negatively correlated with WY, RC, and SEM, and the perimeter area fractal dimension was positively correlated with WY, RC, SEM, and SSC. The effects of several LMs on the hydrological indices had scale effects. WY/RC and the interspersion and juxtaposition index were negatively correlated in most larger watersheds but were positively correlated in most smaller watersheds. Similar results were found for Shannon’s diversity/evenness index and SEM. In general, an increase in a small patch of landscape and in landscape diversity would increase WY, the fragmentation of LPs would result in more soil erosion, and LPs would affect the relationship between streamflow and sediment yield. As a result, a proper decrease in landscape fragmentation and physical connectivity in the subtropical monsoon climate zone of southeastern China would benefit soil erosion prevention. These results enhance the knowledge about the relationship between LPs and hydrological processes in the subtropical monsoon climate zone of southeastern China and benefit local water and soil conservation efforts.