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Efforts to understand macroplastic pollution have primarily focused on coastal and marine environments to the exclusion of freshwater, terrestrial, and urban ecosystems. To better understand macroplastics in the environment and their sources, a dual approach examining plastic input and leakage can be used. In this study, litter aggregation pathways at 40 survey sites with varying ambient population counts in the Ganges River Basin were surveyed in pre- and postmonsoon seasons. We examine active litter leakage using transect surveys of on-the-ground items, in conjunction with assessments of single-use plastic consumer products at the point of sale. We find that sites with low populations have a significantly higher number of littered items per 1,000 people than those with mid to high populations. Over 75% of litter items were plastics or multimaterial items containing plastic, and tobacco products and plastic food wrappers were the most recorded items. There was no significant variation of litter densities pre- and postmonsoon. Most single-use plastic consumer products were manufactured in-country, but approximately 40% of brands were owned by international companies. Stratified sampling of active litter input and consumer products provides a rapid, replicable snapshot of plastic use and leakage.