With the pervasive consumption (currently >65% of total market shares and steadily increasing) of petroleum-derived synthetic textiles, the escalating concern of microfiber fragment (MF) pollution has emerged as a formidable menace to our ecological equilibrium. Over the lifetime (pre- and post-consumption) of these textiles, they shed tiny fibers recognized as MFs. These MFs are carriers of persistent organic pollutants and have been linked to cytotoxicity, oxidative stress, and genotoxicity, even at minimal exposures via air and water sources. Grounded in the state-of-the-art literature, this review discusses the primary and secondary sources of MF release, their fate, transport, environmental impacts, and novel technologies for MF pollutant remediation. Our results infer that MF pollution is a multifactorial issue with serious environmental and public health implications, as studies reported their presence in human blood, feces, and urine samples. We recommend a multifaceted approach to increase sanitation coverage, ensuring adequate wastewater treatment prior to environmental discharge for MF pollution mitigation. Additionally, transformation is warranted for consumers’ use, care, and purchase behavior of textile products. Government regulation of fast fashion (a major user of synthetic textiles), exemplified by recent French legislation, is essential to preventing microfiber pollution. We urge similar policy-making efforts globally to safeguard public health.