Ecosystem services generate enormous benefits to human well-being and act as a “vital lifeline” for socioeconomic development. Undisturbed ecosystems aid in climate regulation, flood regulation, and water purification and sustain the hydrological cycle, carbon cycle, and nutrient cycle. The Bui Dam in Ghana was commissioned in 2013 to provide socioeconomic benefits including irrigation and energy generation. However, the construction of the Bui Dam accompanied by its resettlement projects has intensified competition for natural resources (land, fish, and forest products) and thus compromised the quality of freshwaters within its environs. Therefore, this chapter examines the impacts of landscape modifications and the growing pressure from hydroelectric dams on ecosystem services in water-dependent communities within the Bui Dam area in Ghana. The study has shown that the land use and land cover has changed faster in Bui River basin due to construction of the dam which impacted the riparian ecosystems. Also, the LULCC has led to soil erosion and sedimentation which has consequently resulted in the siltation of the Bui reservoir.