Biomass-to-biofuel conversion represents a critical component of the global transition to renewable energy. One of the most accessible types of biomass is sewage sludge (SS). This by-product from wastewater treatment plants (WWTPs) contains microplastics (MPs) originating from household, industrial and urban runoff sources. Due to their small size (<5 mm) and persistence, MPs present a challenge when they are removed from sewage systems, where they mainly accumulate (~90%). The presence of MPs in SS poses environmental risks when biosolids are applied as fertilizer in agriculture or incinerated for the purpose of energy production. The key problem is the efficient and reliable identification and reduction of MPs in sewage systems, due to the lack of standardized procedures. The reduction methods for MPs might involve physical, chemical, biological, and hydrothermal approaches, including hydrothermal carbonization (HTC). The HTC of SS produces hydrochar (HC), a solid biofuel, and presents a cutting-edge approach that simultaneously addresses secondary microplastic pollution and renewable biomass-derived energy production. In this article, we review briefly the MPs content in biosolids from different countries, and present HTC as a promising method for their removal from SS. In conclusion, HTC (i) effectively reduces the abundance of MPs in biosolids, (ii) produces an improved solid source of energy, and (iii) contributes to circular SS management.