Many studies have focused on the impacts of rainfall duration and intensity while overlooking the role of rainfall patterns on intensive tillage erosion in hilly agricultural landscapes. The objective of this study was to determine the combined effects of rainfall patterns and intensive tillage erosion on surface runoff and soil loss on sloping farmland in the purple-soil area of China. Five simulated rainfall patterns (constant, rising, falling, rising-falling, and falling-rising) with the same total precipitation were designed, and the intensive tillage erosion treatment (IT) and no-tillage treatment (NT) were subjected to simulated rainfall using rectangular steel tanks (2 m × 5 m) with a slope of 15°. To analyse the differences in the hydrodynamic characteristics induced by tillage erosion, we calculated the flow velocity (V), Reynolds number (Re), Froude number (Fr), and Darcy-Weisbach resistance coefficient (f). The results indicate that significant differences in surface runoff and soil loss were found among different rainfall patterns and stages (P < 0.05). The falling pattern and falling-rising pattern had faster runoff-initiating times and larger sediment yields than those of the other rainfall patterns. f varied from 0.30 to 9.05 for the IT and 0.48 to 11.57 for the NT and exhibited an approximately inverse trend to V and Fr over the course of the rainfall events. Compared with the NT, the mean sediment yield rates from the IT increased the dynamic range of 8.34%–16.21% among different rainfall patterns. The net contributions of the IT ranged from 2.77% to 46.39% on surface runoff and 10.14%–78.95% on soil loss on sloping farmland. Surface runoff and soil loss were positively correlated with rainfall intensity, V, and Fr but negatively correlated with f irrespective of tillage intensive (P < 0.05). For varying-intensity rainfall patterns, soil and water loss fluctuated during rainfall events, suggesting that the changes in rainfall intensity and tillage intensity would result in drastic variations in soil hydrological characteristics and sediment transport mechanisms. The time sequences of rainfall intensity in each rainfall pattern significantly affected surface runoff, soil erosion, and their contribution rates to total soil and water loss. Moreover, tillage erosion effects on soil and water loss were closely related to rainfall patterns in hilly agricultural landscapes. Our study not only sheds light on the mechanism of tillage erosion and rainfall erosion but also provides useful insights for developing tillage-water erosion prediction models to evaluate soil and water loss on cultivated hillslopes.