Coral reefs possess extremely high ecological value in tropical and subtropical waters worldwide. Microplastics as emerging and pervasive pollutants pose a great threat to the health of coral ecosystems. However, in situ studies on microplastics pollution and its impacts in coral ecosystems globally are limited. The occurrence characteristics of microplastics in the environment mediums and reef-dwelling organisms were investigated in coral reef areas from the southern Hainan Island, and the impacts of microplastics on corals in situ were evaluated in this study. Average microplastics abundance was 9.48 items L-1 in seawater, 190.00 items kg-1 in sediment, 0.36 items g-1 in coral, 1.50 items g-1 in shellfish, 0.48 items g-1 in fish gill, and 1.71 items g-1 in fish gastrointestinal tract. The prevalent microplastics in the above samples were characterized as being less than 1000 µm in size, fibrous, and transparent, with predominant polymer types as polyethylene terephthalate, polypropylene, polyethylene, and rayon. The microplastic enrichment capacity of different corals varied (Pocillopora >Acropora >Sinularia). Notably, microplastics were more abundant on the surface of corals compared to their interiors, with distinct characteristics observed, including larger-sized (>500 µm) and fiber-shaped polyethylene terephthalate microplastics on the surface and smaller-sized (20–200 µm) fragmented polyethylene microplastics within coral interiors. Furthermore, the investigation showed species-specific impacts of microplastics on corals in situ, including photosynthetic activity of photosymbionts and antioxidant and immune activities of corals. Furthermore, the ecological risks of microplastics were minor across most environmental media in the studied areas, with exceptions in the bottom seawater and surface sediment of YLW, which exhibited extreme and medium risk levels, respectively. Coral risk levels were generally medium, except for dangerous levels in DDH and high levels in LHT. The potential sources of microplastics in the marginal reefs of southern Hainan Island were primarily tourism, residential, and fishing activities.