The burgeoning industrialization and urbanization along the Indian coastline have led to an increased prevalence of port infrastructure and effluent discharge, raising concerns about their potential impact on the delicate macrobenthic communities in coastal ecosystems. This comprehensive review aims to evaluate and synthesize existing literature on the ecological repercussions of port activities and effluent discharge on macrobenthic organisms in Indian coastal regions. The study encompasses a thorough analysis of relevant research articles, government reports, and scientific databases, focusing on diverse ecosystems such as estuaries, mangroves, and open coastlines. The review discusses the various stressors associated with port operations, including dredging, habitat alteration, and chemical contamination from effluent discharge. Furthermore, it explores the response mechanisms of macrobenthic communities, encompassing changes in species composition, abundance, and diversity. Special attention is given to the potential long‐term impacts on ecosystem functioning and services. The synthesis of available data enables the identification of knowledge gaps and the formulation of recommendations for future research and management strategies. Understanding the cumulative effects of port activities on macrobenthic communities is crucial for developing sustainable practices and policies to mitigate adverse impacts while fostering the resilience of coastal ecosystems in the face of anthropogenic pressures. This review contributes to the growing body of knowledge on the ecological consequences of human activities in Indian coastal areas, providing valuable insights for researchers, policymakers, and environmental managers alike.