<p>Microplastic pollution has emerged as a global environmental concern, with diverse consequences for ecosystems and human health. While the focus has primarily been on the sources and impacts of microplastics, this review paper explores the roles of cement and concrete in potentially mitigating microplastic pollution and addressing their negative impacts with the focus of 165 relevant publications. Cementitious materials, widely used in construction, have unique properties that greatly increase the formation and transport of microplastics in the environment, and affect circular economy practice. This paper gathers all the information we already know about how cement, concrete, and microplastics interact with each other. It also presents the potential opportunities and challenges of using these materials to deal with microplastic pollution, entailing the advancement of porous concrete as a filtering system, exploration of concrete wetting phenomena based on concrete’s surface chemistry and characteristics, proper urban water management systems for concrete green spaces, assessment of innovative technologies with concrete for microplastic mitigation, and the formation of standards and guidelines such as precise Life Cycle Assessment (LCA) tools, environmental product declaration (EPD), policy for urban planning, and green finance paradigms.</p>