Topography influences ground motion and, in general, increases the amplitude of shaking at mountain tops and ridges, whereas valleys have reduced ground motions, as is observed from data recorded during and after real earthquakes and from numerical simulations. However, recent publications have focused mainly on the implications for ground motion in the mountainous regions themselves, whereas the impact on surrounding low-lying areas has received less attention. Here, we develop a new spectral-element mesh implementation to accommodate realistic topography as well as the complex shape of the Taipei sedimentary basin, which is located close to the Central Mountain Range in northern Taiwan. Spectral-element numerical simulations indicate that high-resolution topography can change peak ground velocity (PGV) values in mountainous areas by ±50% compared to a half-space response. We further demonstrate that large-scale topography can affect the propagation of seismic waves in nearby areas. For example, if a shallow earthquake occurs in the I-Lan region of Taiwan, the Central Mountain Range will significantly scatter the surface waves and will in turn reduce the amplitude of ground motion in the Taipei basin. However, as the hypocenter moves deeper, topography scatters body waves, which subsequently propagate as surface waves into the basin. These waves continue to interact with the basin and the surrounding mountains, finally resulting in complex amplification patterns in Taipei City, with an overall PGV increase of more than 50%. For realistic subduction zone earthquake scenarios off the northeast coast of Taiwan, the effects of topography on ground motion in both the mountains and the Taipei basin vary and depend on the rupture process. The complex interactions that can occur between mountains and surrounding areas, especially sedimentary basins, illustrate the fact that topography should be taken into account when assessing seismic hazard.