Abstract: Landscape indices are quantitative indices used to reflect the composition and spatial configuration of a landscape ecological structure. Current landscape index systems are generally constructed based on the characterization of 2D spatial characteristics, thus their evaluation results fail to accurately reflect the pattern and composition of a real 3D landscape system. Accordingly, there is an urgent need to develop an index system used to describe the 3D landscape characteristics of islands and a whole-process evaluation method. With Tianheng Island in Shandong Province as a case study and based on the point clouds of unmanned aerial vehicle (UAV) tilt photogrammetry, as well as the classification and processing of point clouds using the deep learning method, this study constructed six basic 3D landscape indices covering type and landscape scales to quantitatively describe the 3D landscape features of the island. Moreover, this study established the building landscape indices to evaluate the impacts of the construction activities of human beings on the island ecosystem. The results are as follows: ① As revealed by the analysis of basic 3D landscape indices, the buildings on Tianheng Island are characterized by small 3D volumes and dense spatial distribution. Furthermore, tall vegetation exhibits high isolation, regularity, and spatial aggregation, while low vegetation exhibits high diversity, compactness, and connectivity; ② Due to the difference in dimension, 3D landscape indices contain more spatial information than 2D landscape indices and are greatly affected by terrain undulation; ③ In the case of the same landscape type, the landscape shape index (TLSI) is more sensitive to the change in height (sensitivity index: 7.480). In the case of the same landscape index, the building type changes more greatly than vegetation with irregular spatial characteristics (sensitivity index: 5.861) and is influenced by the design characteristics of buildings; ④ Tianheng Island has a 3D building index (TBI) of 0.523, which increases with an increase in the density and complexity of buildings. Compared with building density and spatial congestion indices, TBI can better reflect the influence of artificial structures on the 3D landscape pattern of the island. This study aims to provide methodological support and a case study for the construction of 3D landscape indices based on modern surveying and mapping technology, as well as the planning of 3D spatial landscapes and the development of their management and evaluation system.