Background: Little is known about how chemical water quality is associated with ecological stream health in relation to landuse patterns in a watershed. We evaluated spatial characteristics of water quality characteristics and the ecological health of Dongjin-River basin, Korea in relation to regional landuse pattern. The ecological health was assessed by the multi-metric model of Index of Biological Integrity (IBI), and the water chemistry data were compared with values obtained from the health model. Results: Nutrient and organic matter pollution in Dongjin-River basin, Korea was influenced by land use pattern and the major point sources, so nutrients of TN and TP increased abruptly in Site 4 (Jeongeup Stream), which is directly influenced by wastewater treatment plants along with values of electric conductivity (EC), bacterial number, and sestonic chlorophyll-a. Similar results are shown in the downstream (S7) of Dongjin River. The degradation of chemical water quality in the downstream resulted in greater impairment of the ecological health, and these were also closely associated with the landuse pattern. Forest region had low nutrients (N, P), organic matter, and ionic content (as the EC), whereas urban and agricultural regions had opposite in the parameters. Linear regression analysis of the landuse (arable land; $A_L$) on chemicals indicated that values of $A_L$ had positive linear relations with TP ($R^2=0.643$, p < 0.01), TN ($R^2=0.502$, p < 0.05), BOD ($R^2=0.739$, p < 0.01), and suspended solids (SS; ($R^2=0.866$, p < 0.01), and a negative relation with TDN:TDP ratios ($R^2=0.719$, p < 0.01). Conclusions: Chemical factors were closely associated with land use pattern in the watershed, and these factors influenced the ecological health, based on the multimetric fish IBI model. Overall, the impairments of water chemistry and the ecological health in Dongjin-River basin were mainly attributes to point-sources and land-use patterns.