The study of the effect of vegetation cover on water and sediment content is of great significance for the in-depth understanding of ecological and environmental effects in river basins and the formulation of corresponding management measures. Based on the monitoring data of rainfall and runoff of Panjiazhuang and Dangchengwan Hydrologic Stations in Shule River Basin from 2000 to 2020 and the sediment discharge of Changmabao, methods such as geographic information technology (GIS), landscape pattern analysis, land use transfer matrix, correlation analysis, principal component analysis, and linear regression analysis were used to study water and sediment change, land use pattern, vegetation change characteristics, and local water and sediment change in Shule River Basin and construct vegetation–topographic landscape factors. The main research results are as follows: (1) Vegetation coverage in the Shule River Basin increased year by year from 2000 to 2020, with a cumulative increase of 0.064 in 20 years. Vegetation cover has a significant effect on water and sediment content, and the correlation is −0.966. (2) The cultivated land area of the Shule River Basin increased by 604 km2 from 2000 to 2020, and the conversion rate was 67%. From 2000 to 2020, the water area increased by 442 km2, and the conversion rate was 51%. The area of grassland and forest increased by 198 km2 and 12 km2, respectively, and the conversion rate was 68% and 33%, respectively. Forest had the highest transfer rate (0.67). The lowest conversion rate was 0.32 for grassland. (3) The variation coefficient of water and sediment content in Shule River Basin during 1971–2020 was 45.21%, and the highest variation coefficient during 2001–2010 was 49.15%. The lowest variation coefficient was 39.73% during 2011–2020. The annual sediment transport in the Shule River Basin fluctuates greatly and has a high degree of dispersion during 1971–2020. (4) The results of the landscape index in Shule River Basin during 2000–2020 had a small difference, with a difference of less than 0.5. According to the principal component analysis of landscape index and water and sediment content, the maximum patch index (LPI) had the strongest positive correlation with water and sediment content (0.958). The diversity index SHDI had the strongest negative correlation with water and sediment content (−0.995).