Microplastics (MP) are increasingly recognized as contaminants of concern in the food system due to their widespread presence and potential health risks. This review investigated food contact surfaces and aquacultural and agricultural foods as the primary sources of human ingestion exposure to MP and estimated their prevalence and exposure using both particle count and mass-based approaches. Additionally, the review identified the types of foods most susceptible to MP contamination and high-risk polymers and specific usage conditions that promote MP migration. Evidence of MP infiltration and accumulation in human tissues, including the brain, blood, placenta, liver, kidney, and heart, and their potential risks of adverse health effects are discussed. Perspectives on challenges are discussed, including innovations in analytics and materials, risk assessment on long-term implications, and the establishment of regulatory frameworks for mitigations. The ubiquity and unclear chronic toxicity of MP in foods and human bodies urge further research and coordinated actions to address this public health concern.