In recent years, white pollution caused by waste plastics has attracted widespread attention. Microplastics, which are smaller than 5 mm, are widely distributed in the marine environment. The organisms attached to microplastic surfaces include potential pathogenic bacteria that are harmful to marine life and even human health, as well as plastic-degrading bacteria that can reduce their pollution. Microplastics are difficult to degrade, so they can exist in the aquatic environment for a long time, and the microorganisms attached to their surface can also live stably. In addition, microplastics may pass through the food chain to organisms at higher nutritional levels, and may be eaten by fish and affect fish growth. This paper reviews the distribution of microplastics in the ocean and the potential effects of harmful substances contained or attached to the microplastic surface on organisms. The ecological effects of pathogenic microorganisms attached to the surface of microplastics and plastic decomposition microorganisms, as well as the potential of microplastic transmission to high nutritional levels through the food chain were discussed. The ecological risk of microplastic distribution and surface-attached organisms was analyzed. Furtherly, it is still necessary to understand the impact of plastic waste and microplastics on the marine ecosystem, so as to fully understand the ecological effects of marine microplastics and their attachments, and provide a scientific basis for marine plastic pollution control.