The toxic effect of microplastics (MPs) on living organisms is caused by the plastics and other pollutants attached to their surface. The interaction of MPs with hazardous toxic pollutants such as lead (Pb) is possible due to the large surface area of MPs and the high adsorption capacity of heavy metals such as Pb. When combined with toxic heavy metals, the interaction of MPs with aquatic environments and living organisms leads to environmental and biological problems. When MPs enter water, they form a biofilm under the influence of organic and inorganic substances, significantly altering the adsorption–desorption properties of the heavy metal. The current study aims to understand the effect of Pb-MP interaction on MPs by investigating biofilm formation in MPs. By reviewing the studies in the existing literature, the study analyses how biofilm formation affects the adsorption behavior of Pb heavy metal on the surface of MPs. Furthermore, future perspectives highlight potential research directions aiming to fill the knowledge gaps in this field. Addressing the challenges, it also highlights the need for a multidisciplinary approach to understanding microplastic and heavy metal interactions in aquatic ecosystems and to assess the long-term effects of these interactions on ecology and health.