Membrane fouling is considered a persistent challenge in membrane technology for water and wastewater treatment. Membrane surface patterning is a chemical-free means of controlling membrane fouling. Previous studies mainly focused on nano- and micro-scale patterns, with little attention paid on millimeter-scale patterns on the membrane surface. In this study, the millimeter-scale patterned microfiltration membranes with different pattern heights (PM50, PM55 and PM60) were fabricated, the performances in resisting particle deposition and membrane fouling with synthetic wastewater were examined compared with flat-sheet membrane (FM), and the underlying hydrodynamic mechanism was unveiled using computational fluid dynamics (CFD). CFD simulation results reveal that compared to micro- and nano-scale patterns, millimeter-scale patterns exert a notable increase in maximum velocity, average shear stress and maximum shear stress. All the three millimeter-scale patterned membranes exhibit superior resistance to both particle deposition and membrane fouling than FM, owing to the improvement of hydrodynamic properties instead of enlarged membrane area. PM55 shows the lowest flux decline ratios and least particle/foulant deposition among the three millimeter-scale patterned membranes in both particle deposition and membrane fouling experiments. Pattern height plays a crucial role, as small pattern height cannot generate significant vortices, while high pattern height leads to flow separation. For PM55, the vortices form in the valley regions and locate close to bulk flow, which help transport the deposited particles or foulants back to the bulk flow. The design of pattern configuration is suggested to be tailored based on particle size. Future research can focus on the pilot testing of millimeter-scale patterned membranes, as well as the long-term stability with actual influent.