This review discusses the imminent threat that microplastics (MPs) associated with pharmaceuticals represent to the aquatic environment and public health. We initially focused upon recognizing and stressing that MPs are ubiquitous pollutants. The influence of environmental factors, such as pH, mechanical stress, and photodegradation, are examined, aiming to elucidate how both substances might associate, what are their simultaneous degradation pathways and, to understand the interactions between MPs and pharmaceuticals. Mathematical tools, such as modeling and simulations, are presented in detail, aiming to improve how information is interpreted. Furthermore, it is exhibited that MPs sorption and interaction behavior towards organic contaminants play an important role in understanding its dynamics in the environment, as well as their possible interactions with pharmaceuticals that are summarized. At last, MPs and pharmaceuticals toxicity and bioaccumulation are presented. Display omitted •Weathering heavily influence MPs sorption of organic contaminants.•Understanding MPs sorption modeling can improve further data interpretation.•MPs and pharmaceuticals, when combined, present increased toxicity.•MPs influence on pharmaceuticals degradation in the environment remains unclear.