Land use intensification and climate change have resulted in substantial changes in the provision of ecosystem services, particularly in China that experienced sharp increases in population growth and demands for goods and energy. To protect the environment and restore the degraded ecosystems, the Chinese government has implemented multiple national ecological restoration projects. Yet, the combined effects of climate change and land use and land cover change (LULCC) over large spatial scales that brace multiple land use decisions and great environmental heterogeneity remain unclear. We assessed the combined effects of LULCC and climate change on water-related ecosystem services (water provision and soil conservation services) from 1990s to 2020s in Northeast China using the Integrated Valuation of Ecosystem Services and Trade-offs (InVEST) model. We found that water yield decreased by 9.78% and soil retention increased by 30.51% over the past 30 years. LULCC and climate change exerted negative effects on water yield whereas they both enhanced soil retention; LULCC interacted with climate change to have relatively small inhibitory effects on water yield and large facilitation effects on soil retention. Changes in water yield were mainly attributed to climate change, while soil retention was largely influenced by LULCC and its interaction with climate change. Our research highlights the importance of land use decisions and its interactive effects with climate change on ecosystem services in a heavily disturbed temperate region, and provides important information to inform future land management and policy making for sustaining diverse ecosystem services and ensuring human wellbeing.