The ecological integrity of lotic ecosystems is influenced by land cover type and human activity throughout the watershed. This study evaluated Nakdong River conditions in 2016 using two multi-metric models, the index of biotic integrity (IBI) and the water pollution index (WPI), and compared model outputs for four land cover types: predominantly urban, forest, barren land, and agricultural. The primary objective of this study was to determine whether the land cover type and human disturbance metrics effectively regulate water quality, fish communities, and ecological integrity in the Nakdong River basin. Predominantly forest sites had low nutrient, organic matter, suspended solids, ion, and algal chlorophyll concentrations. In contrast, these concentrations were higher in predominantly agricultural, urban, and barren land areas. Concentrations of nutrients, organic matter, ions, suspended particle loadings, and algal growth regulated by the intensity of the Asian summer monsoon. Model outputs indicated that total phosphorus (TP) was the most important factor in algal growth in agricultural (R2 = 0.25) and barren land (R2 = 0.35) sites, and evidence of P limitation was found, with TN:TP ratios >17 in ambient water. Fish community analysis indicated that tolerant species dominated the fish community in the agricultural (52%), barren land (85%), and urban sites (53%), and sensitive species were dominant in the forest sites (56%). Fish composition analysis indicated that two exotic species (Lepomis macrochirus (3.99%) and Micropterus salmoides (3.92%)) were identified as the fifth and seventh most abundant fish species in the watershed and labeled as “ecologically disturbing species” in Korea. Nutrient enrichment, organic pollution, and algal blooms enhanced the mean relative abundance of omnivorous and tolerant fish species. Mean WPI and IBI scores indicated fair or poor conditions in the agricultural (WPI: 22, IBI: 16), barren land (WPI: 21, IBI: 14), and urban (WPI: 21, IBI: 17) sites and good or fair conditions in forest (WPI: 28, IBI: 21) sites. The chemical (r = −0.34) and biological (r = −0.21) health of the river basin were negatively related to human disturbance metrics. The findings suggested that regional land cover, summer monsoon intensity, and human disturbance are important drivers of water quality, fish community, and ecological health. The resulting information suggested that agricultural diffuse pollution control, cutting-edge wastewater treatment technologies, and reducing the degrees of human disturbance could improve the Nakdong River’s ecological integrity.
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