Airborne microplastic (NP) and nanoplastic (MP) pollution has emerged as a pressing environmental concern with significant implications for human health. While MPs are present both indoors and outdoors, indoor concentrations are generally higher due to the abrasion of household materials, furniture, and other domestic sources. MPs and NPs, when inhaled, accumulate in various lung regions, exerting toxic effects and potentially leading to respiratory diseases. This systematic review, conducted according to PRISMA guidelines, evaluates recent experimental studies on the pathogenic impact of nanomicroplastics (NMPs) on lung tissues using in vivo and in vitro models. The review included 10 studies analyzing MP accumulation in respiratory tissues and 90 studies examining pathogenetic mechanisms of MP exposure. Research data indicates a predominance of polymeric fibers such as polypropylene, polyethylene terephthalate, and polytetrafluoroethylene, with fibers accounting for nearly half of MP structures. NMPs in lung tissues exhibit size- and composition-dependent accumulation, with smaller and positively charged particles showing higher translocation potential to the systemic circulation and other organs. The review highlights the synergistic toxic effects of MPs with heavy metals and other pollutants, interaction with pulmonary surfactant, and the role of NMPs in exacerbating respiratory and systemic diseases. Current analysis underscores the growing interest in NMP-related respiratory health risks and identifies significant knowledge gaps, including the need for standardization in NMP toxicity testing and further exploration of NMPs interaction with biological systems. The findings emphasize the importance of mitigating NMPs exposure to safeguard respiratory health and pave the way for future research on the long-term impacts of airborne NMPs on human and environmental health.