<p>Microplastics and nanoplastics are pervasive in aquatic environments, presenting significant global challenges due to their high toxicity. Their small size, extensive surface area, and hydrophilic and lipophilic properties enable them to effectively adsorb hazardous chemicals, including pesticides. These contaminated microplastics and nanoplastics are readily transported within ecosystems, facilitating the dispersion of pollutants through water flow and resulting in adverse effects on aquatic organisms. Additionally, these pollutants can enter the human food chain, posing health risks. This review synthesizes existing research on the interactions between microplastics and nanoplastics and pesticides, examining their distribution patterns, mechanisms of interaction, and regulatory factors. It also evaluates the co-toxicity of these pollutants on aquatic life and human health. Furthermore, the review discusses various removal techniques aimed at mitigating their environmental and health impacts, proposing regulatory frameworks and identifying future policy and research directions to reduce their effects. This review also recommends including the development of environmentally sustainable methods for pollutant removal, such as biodegradable alternatives to plastics and improved recycling practices, to address the proliferation of microplastics, nanoplastics, and associated pesticides globally.</p>