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Microplastics are a silent threat that represent a high degree of danger to the environment in its different ecosystems and of course will also have an important impact on the health of living organisms. It is evident the need to have effective treatments for their treatment, however this is not a simple task, this as a result of the behavior of microplastics in wastewater treatment plants due to their different types and nature, their long molecular chain, reactivity against water, size, shape and the functional groups they carry. Wastewater treatment plants are at the circumference of the release of these wastes into the environment. They often act as a source of many contaminations, which makes this problem more complex. Challenges such as detection in the current scenario using the latest analytical techniques impede the correct understanding of the problem. Due to microplastics, treatment plants have operational and process stability problems. This review paper will present the in-depth situation of occurrence of microplastics, their detection, conventional and advanced treatment methods as well as implementation of legislations worldwide in a comprehensive manner. It has been observed that no innovative or new technologies have emerged to treat microplastics. Therefore, in this article, technologies targeting wastewater treatment plants are critically analyzed. This will help to understand their fate, but also to develop state-of-the-art technologies or combinations of them for the selective treatment of microplastics. The pros and cons of the treatment methods adopted and the knowledge gaps in legislation regarding their implementation are also comprehensively analyzed. This critical work will offer the development of new strategies to restrict microplastics.