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In recent decades, the concept of Ecosystem Services (ES) has generated a paradigm shift in the perspective of human society on nature and has had an important awareness-raising role concerning the importance of ecosystems. However, the concept has not been capable to stop the loss of biodiversity and nature in order to meet the societal challenges of ES provision, especially in urbanized territories. From the reviewed literature, it is obvious that implementing the ES concept within spatial design and planning processes poses several difficulties. In this context we state that a more comprehensive approach is needed of which the ES concept is part. To move to genuine landscape change and a shift in land use and land stewardship, we argue that a landscape design approach can play a significant activating role. The goal of this paper is to underpin this assumption from a theoretical and methodological point of view. The paper first gives an overview of the difficulties that the field of ES science and practice is facing when implementing the ES concept in landscape design and planning processes. Then a landscape design approach is presented as an alternative approach and a possible way forward for genuine landscape change to meet the societal demand for ES.