The increase in plastic debris and its environmental impact has been a major concern for scientists. Physical destruction, chemical reactions, and microbial activity can degrade plastic waste into particles smaller than 5 mm, known as microplastics (MPs). MPs may eventually enter aquatic ecosystems through surface runoff. The accumulation of MPs in aquatic environments poses a potential threat to finfish, shellfish, and the ecological balance. This study investigated the effect of MP exposure on freshwater and marine fish. MPs could cause significant harm to fish, including physical damage, death, inflammation, oxidative stress, disruption of cell signalling and cellular biochemical processes, immune system suppression, genetic damage, and reduction in fish growth and reproduction rates. The activation of the detoxification system of fish exposed to MPs may be associated with the toxicity of MPs and chemical additives to plastic polymers. Furthermore, MPs can enhance the bioavailability of other xenobiotics, allowing these harmful substances to more easily enter and accumulate in fish. Accumulation of MPs and associated chemicals in fish can have adverse effects on the fish and humans who consume them, with these toxic substances magnifying as they move up the food chain. Changes in migration and reproduction patterns and disruptions in predator-prey relationships in fish exposed to MPs can significantly affect ecological dynamics. These interconnected changes can lead to cascading effects throughout aquatic ecosystems. Thus, implementing solutions like reducing plastic production, enhancing recycling efforts, using biodegradable materials, and improving waste management is essential to minimize plastic waste and its environmental impact.