Plastic pollution in aquatic environments is a recognized environmental threat on a global scale and is fed by the linear economy model of “make-use-dispose,” which underpins both the fossil fuel and plastic industries. This chapter examines the issue of microplastic pollution in different freshwater environments: (i) rivers and tributaries, (ii) lakes, (iii) groundwater sources, (iv) glaciers and ice caps, and (v) deltas. Particular challenges, the geographical coverage of studies, and current knowledge gaps are highlighted for each freshwater category based on the currently available peer-reviewed literature. Sources and distribution of microplastics in freshwater bodies and associated repercussions to freshwater ecosystems and human health are also reviewed. A better understanding of microplastic interactions between human settlements and freshwater environments in different parts of the globe is required to better enact evidence-based mitigation measures that will be able to further limit the spread of microplastic pollution in the natural environment. Therefore, research on microplastic pollution in freshwater bodies around the world must be further supported to provide a reliable global database and compliant monitoring procedures. Additionally, further research can better inform policies and regulations around plastic use and emission into the environment at both the global and local scales.