Soil ecosystems are increasingly exposed to combined contamination by microplastics (MPs) and heavy metals (HMs), yet the interaction does not follow one generic pattern across metals. This review focuses on five priority heavy metals (Pb, Cr, Cd, As, and Hg) and compares their differential responses to interactions with conventional and biodegradable MPs under changing particle size, oxidation, biofilm/eco-corona development, pH, dissolved organic matter, and redox conditions. We show that the oxidation–biofilm synergy does not act uniformly: it most consistently strengthens Pb/Cd complexation and carrier-assisted enrichment, modulates Cr mainly through the coupling of adsorption with valence transformation, reshapes As's sorption–methylation pathways, and alters Hg predominantly through dissolved organic matter (DOM)-mediated transformation rather than sorption alone. We further show that conventional and biodegradable MPs can regulate heavy metals' mobility, bioavailability, trophic transfer, and ecological risk in contrasting ways, especially in the rhizosphere and in multimetal settings. On this basis, the review advances three linked contributions: a comparative framework for metal-specific differential responses, a direct comparison between conventional and biodegradable MPs, and a metal–polymer-specific remediation design framework for complex co-contaminated soils. Finally, we identify priorities for future work, including long-term field validation, multimetal competition, time-resolved aging of biodegradable MPs, cross-trophic transfer, and mechanism-guided remediation that jointly suppresses MPs' carrier effects and HMs' bioavailability.