<p>The presence of microplastics in drinking water has attracted widespread attention worldwide and has raised concerns regarding the potential adverse impacts of microplastics on human health. This study was compiled from published data on microplastics (MPs) in South American countries to assess the current status of microplastic contamination in drinking water, followed by health risk assessment. The results revealed significant variations in the mean concentrations, ranging from a minimum value of 0.0009 particles/L and maximum value of 391 particles/L in this region. The primary polymer types identified in the reviewed studies included polyethylene terephthalate (PET), polystyrene (PS), polypropylene (PP), polyurethane (PU), polyester (PES), polyacrylamide (PA), high-density polyethylene (HDPE), low-density polyethylene (LDPE), expanded polystyrene (EPS), polyvinyl chloride (PVC), and polyethylene (PE), with sizes ranging from 0.5 to 2500&#xa0;μm. In this study, Brazil and Ecuador presented a greater risk of MPs in drinking water with respect to the hazard index (HI). The pollution load index (PLI) also falls into the higher risk category in Chile and Brazil, and potential ecological risk index (PERI) values fall at higher risk in all countries except Colombia. In Chile, the estimated daily intake (EDI) was found to be greater in children than in adults. Furthermore, these analyses were employed to evaluate the potential adverse effects on human health and to offer a comprehensive assessment of MP contamination in drinking water, which can be further utilized to improve water quality. This study offers valuable insights for policymakers and public health initiatives, contributing to efforts to mitigate microplastic pollution. Additionally, it aligns with key United Nations Sustainable Development Goals (SDGs), particularly SDG-3 (Good Health and Well-Being), SDG-6 (Clean Water and Sanitation), and SDG-12 (Responsible Consumption and Production).</p> Graphical abstract <p></p>