Context: The karst region of southwestern China, one of the largest continuous karsts in the world, is known for its unique landscapes and rich biodiversity. This region has suffered severe environmental degradation (e.g., vegetation cover loss, soil erosion and biodiversity loss). In recent decades, Chinese governments at different levels have initiated several ecological programs (e.g., Green for Grain, Mountain Closure) to restore the degraded environment and to alleviate poverty. Objectives: This study summarizes landscape studies of karst landscapes patterns, their dynamics and interactions among landscape pattern, hydrological processes and ecosystem services (ES). Methods: We conducted a systematic literature review of science and land use policy to identify knowledge gaps and recommend future research and policy directions. Results: Karst landscapes have experienced rapid turnover in recent decades due largely to the overlap of intense human activity on the fragile karst ecosystems. Many studies have comprehensively examined hydrology, soil processes and ecosystem services (ES) and their relationships with landscape pattern. Most of these studies have found that karst ecosystems recover with improved ES. However, the importance of epikarst in hydrological and soil processes, intense anthropogenic disturbance and landscape heterogeneity in landscape models remains elusive. Conclusions: Future research should focus on in-depth examination and modelling of karst specific hydrological and soil processes, investigating relationships between climatic change, landscape change, ecological processes, and region-specific ES assessments. Results from such research should provide the necessary scientific support for a comprehensive, national karst rocky desertification treatment project (Stage II) and poverty alleviation initiatives.