Microplastics (MPs) and polycyclic aromatic hydrocarbons (PAHs) are universally detected in the marine ecosystem and may exert adverse impacts on marine species. Although under realistic pollution scenarios, PAH pollution usually occurs as a mixture of different PAH compounds, the toxic impacts of PAH mixtures on marine organisms remain largely unknown to date, including their interactions with other emergent pollutants such as MPs. In this study, the single and combined toxic impacts of polystyrene MPs and a mixture of PAHs (standard mix of 16 representative PAHs) on haematic parameters were evaluated in the blood clam Tegillarca granosa. Our data demonstrated that blood clams treated with the pollutants examined led to decreased total haemocyte count (THC), changed haematic composition, and inhibited phagocytosis of haemocytes. Further analyses indicated that MPs and a mixture of PAHs may exert toxic impacts on haematic parameters by elevating the intracellular contents of reactive oxygen species (ROS), giving rise to lipid peroxidation (LPO) and DNA damage, reducing the viability of haemocytes, and disrupting important molecular signalling pathways (indicated by significantly altered expressions of key genes). In addition, compared to clams treated with a single type of pollutant, coexposure to MPs and a mixture of PAHs exerted more severe adverse impacts on all the parameters investigated, indicating a significant synergistic effect of MPs and PAHs.