Microplastics (MPs) are widespread in everyday life, and since wastewater treatment plants (WWTPs) serve as an important route for MPs to enter natural water bodies, a thorough understanding of the distribution and removal of MPs in wastewater treatment plants is of great importance. This article provides a comprehensive overview of the measured distribution of MPs and the current status of their removal in wastewater treatment plants. The main sources of MPs in wastewater treatment plants are personal care products in domestic wastewater, textile clothing and industrial wastewater made from plastics, textile factories and the friction of road tires. The MPs that entered the sewage treatment plant were predominantly in the form of fibers, fragments, granular MPs and other types of MPs. The size of MPs is divided into three categories: <0.5 mm, 0.5–1 mm and 1–5 mm. At all treatment stages in wastewater plants, 56.8–88.4 % of MPs are removed in primary treatment, but the primary sedimentation and degreasing stages remove most MPs. The efficiency of the activated sludge process for secondary treatment is inconsistent and is generally between 42.1 and 99.2 %. The coagulation, filtration and disinfection stages of tertiary treatment all have some MPs removal capacity. In addition, novel removal technologies are also described, such as modified filtration technology, membrane separation technology, electroflocculation, sol-gel and photocatalysis. These novel removal technologies can further limit the entry of microplastics into natural water bodies through sewage treatment plants and improved sewage treatment processes help reduce the risk of MPs entering the natural environment through sewage treatment plants. This article will provide reference for the distribution and removal of microplastics in various levels of WWTPs.