How to reduce microplastic pollution in aquatic ecosystem has become the focus of the global attention. The re-removal of microplastics of wastewater treatment plant (WWTP) effluent is gradually being put on the agenda. Recently, algae have been used as an ecofriendly remediation strategy for microplastic removal. Microplastics in sewage can be removed by algae through interception, capture, and entanglement, and can also form heterogeneous aggregates with algae, thereby reducing their free suspensions. Algae can recover nitrogen and carbon from wastewater and can be made into biochar, biofertilizers, and biofuels. However, problematically, this technology has been in the laboratory research stage, and existing research results cannot provide effective basis for its application. Microplastic removal via algae is influenced by wastewater flow rate, microplastic types, and pollutants. Microplastics are only physically fixed by algae, and ensuring that microplastics do not re-enter the environment during resource and capacity recovery is also a key factor limiting the implementation of this technology. The topic of this paper is to discuss the performance of the current tertiary wastewater treatment process - algae process to remove microplastics. Algae can remove nitrogen and phosphorus pollutants in sewage and remove microplastics at the same time, which can realize energy recovery and reduce ecological risks of the effluent. Although algae combined tertiary sewage treatment is a green technology for microplastic removal, its application still needs to be explored. The key challenges that need to be addressed, from single laboratory conditions to complex conditions, from small-scale testing to large-scale simulations, lie ahead of the application of this friendly technology.