Landscapes in semiarid regions are highly sensitive to climate change and anthropogenic activities, and their evolution directly influences ecosystem services and regional ecological security. Although previous research has examined land use changes, systematic quantitative analyses of long-term evolutionary trends and driving mechanisms, particularly the comprehensive relationships between key hydrological elements and landscape pattern evolution in water-scarce, semiarid watersheds, remain limited. To address the research gap in long-term, multifactor, and hydro-landscape integrated analysis, China's Tuwei River watershed was selected as the study area in this study, and methods such as landscape pattern indices and gray relational analysis were employed to quantitatively reveal the spatiotemporal evolution of watershed landscape fragmentation from 1980 to 2020 and identify its dominant driving forces. The results revealed that (1) over the 40-year period, the land use structure of the watershed underwent significant restructuring, with developed land expanding by 1282%, cropland and bare land areas decreasing by 14.2% and 32.01%, respectively, and grassland and forestland areas increasing by 24.5% and 14.9%, respectively; (2) land-scape fragmentation continued to intensify, with the landscape fragmentation composite index (FCI) increasing by 37.6%, patch density (PD) continuously increasing, edge density (ED) and landscape shape index (LSI) increasing significantly, and landscape connectivity weakening; (3) natural and socioeconomic factors jointly drove landscape evolution, with temperature and mean annual flow contributing the most among natural factors and the urbanization rate and secondary industry output value serving as the core drivers among socioeconomic factors; and (4) the trend of landscape fragmentation was synchronized with changes in annual rainfall and runoff and exhibited a significant negative correlation with the groundwater level. In summary, through long-term, multifactor comprehensive analysis, the evolution characteristics and driving mechanisms of landscape patterns in the Tuwei River watershed were systematically revealed in this study. These findings not only deepen the understanding of landscape fragmentation processes under the dual pressures of climate change and anthropogenic activities but also provide scientific evidence for the sustainable management of landscapes and associated ecosystems in semiarid watersheds.