The Caribbean Coast of Colombia has a flourishing plastic industry with weak and insufficient waste management policies and practices, leading to plastic pollution along its touristic beaches. In this work, primary and secondary microplastics (MPs) were surveyed at four different locations along the Colombian Caribbean Coast. Primary microplastics, specifically white new plastic pellets, represented the largest amount of MPs found, with densities decreasing in the order Cartagena > Coveñas > Puerto Colombia > Riohacha. This distribution was connected to the vicinity of MPs sources, marine currents and wind direction. The presence of secondary MPs was associated with urban centers and proximity to river mouths. The FTIR characterization showed polyethylene as the predominant resin type, with different degrees of surface oxidation. Aqueous extracts from sampled MPs were tested on Caenorhabditis elegans. Secondary MPs elicited greater toxicological responses than pellets, especially those from Cartagena Bay, suggesting MPs act as carriers for biologically-active pollutants.