Owing to extensive plastic consumption, wastewater from households, business establishments, and industrial activities have been recognised as a significant contributor to microplastics (MPs) in aquatic environments. This case study represents the first investigation of MPs in the Nakdong River, Republic of Korea, that traverses through the largest industrial complex midstream and densely populated cities of Daegu and Busan downstream before flowing into the sea. Monitoring of MP abundance in effluents discharged from three municipal, two industrial, and one livestock wastewater treatment plant (WWTP) into the Nakdong River was conducted over four seasons from August 2022 to April 2023. Identification and quantification of MPs were performed using micro-Fourier transform infrared spectrometry. Seasonal variation in MPs in the Nakdong River was found to be strongly influenced by the nearest upstream WWTPs and rivers, exhibiting a linear relationship that decreased gradually with increasing distance from the WWTPs. The average concentrations of MPs in the six effluent sources ranged from 101 ± 13 to 490 ± 240 particles/L during the yearly monitoring period, while MP concentrations in the river ranged between 79 ± 25 and 120 ± 43 particles/L. Industrial effluents contained higher amounts of discharged MPs (314 ± 78 particles/L) than municipal sources (201 ± 61 particles/L). Notably, two municipal WWTPs, located in the highly densely populated city, discharged the highest total MP amounts per day and released the greatest volumes of effluents. This study provides valuable insights into the monitoring and impact of effluents on MPs in rivers, which could inform MP treatment and management strategies for in river and marine environments.