Assessing and modeling the changes in land use and land cover (LULC) patterns and associated ecosystem service values (ESV) has become an important global agenda for formulating sustainable land management policies. Taking the coastal region of Bangladesh (CRB) as a case study, we utilized remote sensing and GIS techniques to analyze Landsat data of 1999 and 2019 to estimate the effect of LULC changes on the ESVs. The LULC classification, ESV quantification, and spatial variations were performed by semi-automated classification, per-unit value transfer, and spatial autocorrelation techniques, respectively. First, between 1999 and 2019, LULC altered dramatically (agricultural land and coastal wetlands decreased, while all other LULC types increased). Second, the total ESV decreased by 1.87%, which was mostly attributed to a 70% growth in both rural settlement and aquaculture/saltpan, and a 30% decline in both agricultural land and wetlands. Third, significant spatial correlation and moderately high spatial clustering were observed, which consisted mostly of mangrove forests, waterbodies, and wetland zones. Both high-high and low-low values increased, but spatial outliers remained unchanged. Conserving agricultural land should be prioritized in future land use plans of CRB to meet the ever-increasing food demands, control natural land conversion, and make land use sustainable.