Polyethylene (PE) is a common component of microplastic pollution, and cadmium (Cd) is a prevalent pollutant in contaminated freshwater bodies in China. Among cyanobacteria, Microcystis aeruginosa (M. aeruginosa) plays a crucial role in the formation of algal blooms in these water systems. However, there has been limited research on how microplastics and heavy metals affect cyanobacteria ecologically. This study aimed to evaluate the physiological effects of individual and combined exposure to Cd pollutants and microplastics on M. aeruginosa. The solutions containing 13 µm and 6.5 µm PE particles (100 mg/L) with Cd were used in the research. The results indicated that the combined treatment led to a significant inhibition of chlorophyll a content, dropping to zero by day 5. The treated groups exhibited higher microcystins (MCs) content compared to the control group, suggesting increased MCs release due to pollutant exposure. Interestingly, the adsorption of heavy metals by microplastics partially alleviated the toxicity of heavy metals on algal cells. Moreover, the combined treatment significantly suppressed catalase (CAT) activity compared to Cd treatment, indicating a synergistic effect that led to greater oxidative stress. Overall, this study provides valuable insights into the impact of PE and Cd pollution on freshwater ecosystems, elucidates the physiological responses of cyanobacteria to these pollutants, and establishes a theoretical groundwork for addressing complex water pollution using cyanobacteria-based strategies.