It has been shown that ingestion of microplastics may increase bioaccumulation of organic chemicals by aquatic organisms. This paper critically reviews the literature on the effects of plastic ingestion on the bioaccumulation of organic chemicals, emphasizing quantitative approaches and mechanistic models. It appears that the role of microplastics can be understood from chemical partitioning to microplastics and subsequent bioaccumulation by biota, with microplastic as a component of the organisms’ diet. Microplastic ingestion may either clean or contaminate the organism, depending on the chemical fugacity gradient between ingested plastic and organism tissue. To date, most laboratory studies used clean test organisms exposed to contaminated microplastic, thus favouring chemical transfer to the organism. Observed effects on bioaccumulation were either insignificant or less than a factor of two to three. In the field, where contaminants are present already, gradients can be expected to be smaller or even opposite, leading to cleaning by plastic. Furthermore, the directions of the gradients may be opposite for the different chemicals present in the chemical mixtures in microplastics and in the environment. This implies a continuous trade-off between slightly increased contamination and cleaning upon ingestion of microplastic, a trade-off that probably attenuates the overall hazard of microplastic ingestion. Simulation models have shown to be helpful in mechanistically analysing these observations and scenarios, and are discussed in detail. Still, the literature on parameterising such models is limited and further experimental work is required to better constrain the parameters in these models for the wide range of organisms and chemicals acting in the aquatic environment. Gaps in knowledge and recommendations for further research are provided.