It basically means that you should watch everything you do, because it'll lead to bigger consequences.
More specifically, it means
Watch your thoughts because they will become actions
Watch your actions because they will become a habit
Watch your habits because they will define your character
Watch your character because it will change your destiny
"sow" means planting something, and "reap" means harvesting, so it's literally saying:
Plant a thought and harvest an action, etc