This study of Hainan Island, based on three periods of land use/cover data from 2008, 2013, and 2017, uses the intensity analysis model and landscape pattern index to portray the dynamic changes of land use on the island and a quantitative analysis of the spatial and temporal evolutionary characteristics of ecosystem service values (ESV) based on the equivalent factor method. At the same time, the response of ESV to landscape pattern changes is explored. The results indicate: (1) From 2008 to 2017, the cultivated land in the coastal areas around Hainan Island continued to expand, which squeezed out forest land and reduced its area. The growth of built-up areas in Haikou City and Sanya City was more dramatic. (2) A weakening trend in the intensity of land use on Hainan Island during the study period. There were significant changes in cultivated land, grassland, and bare land, with forest land, grassland, and water bodies transformed into cultivated land. Built-up areas increased mainly through the occupation of cultivated land, grassland, and water bodies. (3) The fragmentation of landscape patches and the diversity of landscapes on Hainan Island increased, with the distribution of landscape types tending to be balanced. (4) From 2008 to 2017, the overall ESV of the island showed an initial decrease before increasing; the main spatial distribution characteristic of the ESV was “high in the central and low in the surroundings”. (5) The mean patch area, the Shannon diversity index, and the largest patch index showed clear positive correlations to ESV.