Microplastics (MPs) and their associated chemical additives, such as bisphenol A (BPA), nonylphenol (NP), nonylphenol ethoxylate (NEPO), and tetrabromobisphenol (TBBPA), are widely recognized as significant environmental contaminants due to their widespread presence in ecosystems and their potential impact on human health. This review evaluates advanced treatment technologies, such as membrane filtration and oxidation processes, for mitigating these risks and highlights gaps in sustainability and efficiency. Actionable strategies for improving the removal of MPs and MP additives were presented in the assessment of innovative hybrid treatment tailored to different water matrices. The importance of anti-fouling technologies, comprehensive life cycle assessments (LCAs), and standardizing treatment methods to enhance the sustainability and applicability of these technologies were further highlighted. To further improve and optimize treatment processes and ensure sustainability, existing knowledge gaps must be addressed by framing a comprehensive understanding of the long-term ecological effects of MPs and their additives.