Bangladesh is a deltaic country in Asia, and its riverine systems ultimately drain into the Bay of Bengal. Plastic is a severe environmental issue for coastal-marine ecosystems due to the indiscriminate usage and discarding of plastic items in the upstream river that eventually find their route into the Bay of Bengal. Microplastics (MPs) are widespread pollutants in almost all environmental compartments, including aquatic environments. This study aimed to quantify and understand the distribution of microplastics in surface water and sediments of the river Karnaphuli, a tidal confluence river adjacent to the Chattogram seaport city of Bangladesh, a highly inhabited and industrial area on the southeast coast of the Bay of Bengal. A manta trawl net (300-µm mesh size) was used to collect surface water samples, while an Ekman dredge was used to collect sediment samples. The concentrations of microplastics in the surface water of the river Karnaphuli during late monsoon, winter, and early summer were recorded to be 120,111.11, 152,222.22, and 164,444.44 items/km, respectively, while in sediments, those were recorded to be 103.83, 137.50, and 103.67 items/kg, respectively. A higher abundance of microplastics was observed in downstream surface water (228,888.88 items/km) and sediments (164.17 items/kg). Smaller sizes (0.3 to 0.5 mm) of microplastics were predominant, fibers or threads were the frequent types, and black was the most common color in the river Karnaphuli. The Fourier transform infrared analysis revealed that polyethylene terephthalate (surface water: 22%, sediments: 19%), polyamide (surface water: 15%, sediments: 13%), polyethylene (surface water: 12%, sediments: 18%), polystyrene (surface water: 13%, sediments: 11%), and alkyd resin (surface water: 13%, sediments: 10%) were the most prevalent polymers in the river Karnaphuli. Moreover, there was a moderate positive correlation between MPs abundance in surface water and sediments. Therefore, improved long-term research (in different seasons with horizontal and vertical monitoring) is necessary in order to accurately determine the flux of microplastics from the river Karnaphuli to the Bay of Bengal.