Previous studies have mostly focused on the adsorption behavior of microplastics for antibiotics in soil or aqueous environments. This study explores the adsorption characteristics of microplastics for antibiotics under groundwater environmental conditions and the influence of typical influencing factors of the groundwater environment (pH, pollutant concentration, aquifer media, dissolved organic matter, and ionic strength) on the adsorption process. Polyethylene (PE) and tetracycline (TC) were selected as typical microplastics and antibiotics in the experiment. The study results showed that the adsorption of TC by PE reached equilibrium at 48 h, and the adsorption kinetics fitted pseudo-second-order kinetics models well. The adsorption isotherm was consistent with the Langmuir model. The adsorption capacity of PE for TC was highest under neutral conditions and positively correlated with the initial concentration of TC. The aquifer media exhibited limited effects on the adsorption process. Fulvic acid (FA) significantly suppressed TC adsorption onto PE, attributable to competitive adsorption mechanisms. TC adsorption on PE initially increased then declined with Ca²⁺ concentration due to Ca²⁺ bridging and competition. This research elucidates the adsorption mechanisms of PE towards TC, providing theoretical basis and reference for assessing the environmental risk of microplastics and antibiotics in groundwater.