During the installation and operation of Pelton turbines, deviations of the jet centerline from the runner pitch circle can compromise turbine stability and efficiency. Utilizing design data from a Pelton turbine on China’s Dadu River, this study employs the SST k-ω and VOF models to investigate the flow characteristics, pressure pulsations, and force on the bucket surface under varying offset conditions. The results demonstrate that radial offset causes the jet to enter the bucket later when deflected outward and earlier when deflected inward. All forms of offset exert adverse effects on turbine performance, with axial offsets causing more severe impacts than radial ones. The maximum pressure pulsation amplitude reached 24%. Afterwards, the erosion of Pelton turbines with different grain sizes was investigated by erosion modeling. It was found that the erosion of large grain size is more serious than that of small grain size. This research provides valuable theoretical insights and an important guiding role for improving the operational stability of Pelton turbines.