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Ingestion of microplastics by marine organisms is a common occurrence in marine ecosystems, but the experimental demonstration of the effects of ingested microplastics on marine organisms has only recently become an important subject of research. In this review, the ingestion of microplastics by marine organisms, its attendant potential consequences and specific hypothetical questions for further studies are discussed. The formation of heteroaggregates in the gut of prey organisms may delay microplastic clearance, potentially increasing the chances of microplastic trophic transfer to predators. Also, the survival and energetics of keystone species at lower trophic levels are negatively affected by ingestion of microplastics, thereby raising questions about the transfer of energy and nutrients to organisms at higher trophic levels. Further, since microplastics are able to adsorb and concentrate organic pollutants up to 1 million times more than the pollutant concentration in ambient waters, the ingestion of such small plastic fragments is, a probable route for the entrance and biomagnification of toxic chemicals in the marine food web. However, the equilibrium state between pollutant concentration in marine organisms and that of surrounding waters makes it unclear whether the ingestion of microplastics actually increases the pollutant load of organisms. Finally, microplastic ingestion can cause endocrine disorders in adult fish, which could result in neoplasia via epigenetic programming. Therefore, microplastic pollution may be a contributory cause of increased incidents of neoplasia in marine animals. The amount of microplastics in marine waters will steadily rise, and questions about their impact on marine ecosystems will linger.