Urban sprawl causes changes in land use and a decline in many ecosystem services. Understanding the spatial patterns of sprawl and exploration of citizens’ perception towards the sporadic urban expansion and its impacts on an ecosystem to deliver services can help to guide land use planning and the conservation of the urban ecosystem. Here, we spatially examined land use changes in Multan, Pakistan, and investigated public perception about urban sprawl and its impacts on the quality and provision of ecosystem services, using a survey instrument. The spatial analysis of the historical land cover of Multan indicated an exponential expansion of the city in the last decade. Large areas of natural vegetation and agricultural land were converted to urban settlements in the past two decades. The citizens of Multan believe that the quality and provision of ecosystem services have declined in the recent past and strongly correlate the deteriorating ecosystem services with urban sprawl. Education and income levels of the respondents are the strongest predictors of urban ecosystem health literacy. Citizens associated with laborious outdoor jobs are more sensitive to the changes in ecosystem services. We concluded that the rapidly expanding cities, especially in the tropical arid zones, need to be prioritized for an increase in vegetation cover, and economically vulnerable settlements in these cities should be emphasized in climate change mitigation campaigns.