Microplastic (MP) pollution is a significant worldwide environmental and health challenge. Municipal solid waste (MSW) can be an important source of MPs in the environment if treated and disposed of inappropriately, causing potential ecological risks. MSW treatment and disposal methods have been gradually shifting from landfilling/dumping to more sustainable approaches, such as incineration or composting. However, previous studies on MP characteristics in different MSW treatment and disposal systems have mainly focused either on landfills/dumpsites or composts. The lack of knowledge of multiple MSW treatment and disposal systems makes it difficult to ensure effective MP pollution control during MSW treatment and disposal. Therefore, this study systematically summarizes the occurrence of MPs in different MSW treatment and disposal systems (landfill/dumpsite, compost, and incineration) on the Eurasian scale, and discusses the factors that influence MPs in individual MSW treatment and disposal systems. In addition, the paper assesses the occurrence of MPs in the surrounding environment of MSW treatment and disposal systems and their ecological risks using the species sensitivity distribution approach. The study also highlights recommendations for future research, to more comprehensively describe the occurrence and fate of MPs during MSW treatment and disposal processes, and to develop appropriate pollution control measures to minimize MP pollution.