Among microplastics (MPs), fibers are one of the most abundant shapes encountered in the aquatic environment. Growing attention is being focused on this typology of particles since they are considered an important form of marine contamination. Information about microfibers distribution in the Mediterranean Sea is still limited and the increasing evidence of the high amount of fibers in the aquatic environment should lead to a different classification from MPs which, by definition, are composed only of synthetic materials and not natural. In the past, cellulosic fibers (natural and regenerated) have been likely included in the synthetic realm by hundreds of studies, inflating “micro-plastic” counts in both environmental matrices and organisms. Comparisons are often hampered because many of the available studies have explicitly excluded the micro-fibers (MFs) content due, for example, to methodological problems. Considering the abundance of micro-fibers in the environment, a chemical composition analysis is fundamental for toxicological assessments. Overall, the results of this review work provide the basis to monitor and mitigate the impacts of microfiber pollution on the sea ecosystems in the Mediterranean Sea, which can be used to investigate other basins of the world for future risk assessment.