The lake littoral zone, an important transitional area between land and lake, is an integral part of a healthy lake ecosystem. The evolution of landscape patterns in the lake littoral zone will have an important effect on wetland water quality. Therefore, studying the key littoral zone landscape factors that affect karst wetland water quality changes is of great importance in understanding the process and the underlying mechanism regarding how landscape patterns effect karst wetland water quality. Using Puzhehei karst lake wetland as the study area, and obtaining Landsat remote sensing images and the collected water quality monitoring data from 2005, 2007, 2009, and 2011, we studied the influence of landscape pattern indices on Puzhehei karst lake wetland littoral zone water quality through delineating the buffer zones and using correlation and redundancy analysis. The results showed that the littoral zone landscape patterns were quite different in various buffer zones. The effects of water quality on land use type and landscape pattern indices in the low flow period was greater than that in the high flow period; the landscape patterns had different effects on the water quality of karst lake wetlands at different buffer zones. Individual landscape indices better revealed the influence of landscape pattern evolution on water quality in the Puzhehei karst lake wetland, accompanied by increased buffer zone distances. Among them, Contagion Index, Patch Cohesion Index, and Shannon's Evenness Index values had a substantial influence on water quality, and Area-weighted Mean Patch Fractal Dimension exhibited a significantly negative correlation with water quality parameters. The effects of other landscape indices on water quality were not significant. Among them, the effects of Edge Density and Aggregation Index values on water quality gradually weakened accompanied by the increased buffer region distances. Largest Patch Index values were closely correlated with water quality when the buffer distance was less than 300m. Beyond this, the effect of Shannon's Diversity Index on water quality was uncertain. Additionally, most water quality parameters showed a good correlation with land use type area, and the proportion of wetland area was the main index to characterize the water environment quality of the karst lake wetland.