The evolution of landscape patterns affects the supply of ecosystem services. It is important to explore the relationship between them to improve regional ecological stability and maintain ecological health. The Fenhe River is the second largest tributary of the Yellow River and it represents a fragile ecological environment. Our study aimed to analyze the impact of changes in landscape patterns on the value of ecosystem services (ESV) in the Fenhe River Basin (FRB). Land use data from 2000, 2010, and 2020 were used to extract landscape pattern indices. Methods such as ecosystem service value accounting, sensitivity analysis, correlation analysis, and geodetector modeling were employed to investigate changes in landscape patterns and ESV, and to identify the driving forces and impacts of these changes on ESV. The results showed that (1) from 2000 to 2020, the dominant landscape in the FRB was cultivated land, followed by forestland and grassland, which together covered 92% of the total area. (2) Over the past 20 years, the extent of landscape fragmentation had continued to increase and ecological function had deteriorated. (3) ESV had continued to decrease. The ESV provided by the regulating service function was the largest, accounting for over 49% of the total ESV. Support service function was second, accounting for over 34%. (4) The total ESV had a strong negative correlation with Shannon's diversity index (SHDI) and Shannon's evenness index(SHEI), a significant positive correlation with Contagion index (CONTAG). (5)The Human Activity Index (HAI) had a significant impact on changes in ESV, with an influence value of 0.6192, and its synergistic effect with NDVI further enhances this impact, achieving a synergy score of 0.71. Additionally, natural factors such as topography and climate also had significant effects on ESV changes.This study provides an evidence-based theoretical reference to guide the enhancement of the natural environment of the FRB and maintain highquality development of regional landscapes.