Due to the negative impacts of microplastics (MPs) on the ecosystem, the investigation of its occurrence and its treatment from sewage and wastewater treatment plants (WWTPs) have received a lot of attention in the recent years. Most MPs are precipitated and removed with the sludge during the treatment process. Proper sludge management is immensely necessary to avoid MP exposure in the environment. However, the domestic research on this aspect is limited. This study reviews appropriate sludge management approaches to decrease environmental MP exposure. This can be achieved through investigating sludge generation and treatment, regulation laws and government policy trends with an emphasis on WWTPs. The ratio of sludge in sewage treatment plants has been observed to be highest in recycling followed by incineration and landfills. Recycling is the highest in fuel followed by construction materials and composting. For WWTPs, the highest ratio is in recycling followed by fuel and landfills, and recycling is confirmed in the following order: incineration > after composting > after solidification > earthworm breeding. Treatment approaches that can increase the exposure of MPs to the ecosystem are considered to be used in landfills and agricultural fields. However, this method is not appropriate given the insufficient capacity of domestic landfills and the sufficient supply of existing chemical and animal manure fertilizers. Instead, it would be rational in terms of environmental preservation to expand the use of fuel and energy in connection with the new and renewable energy policy, and to actively seek the use of sub-materials for construction materials. In order to secure the basic data for the effectiveness of future planning and revision of related laws, it is required to perform an in-depth investigation of the sludge supply and demand status along with the environmental and economic effects.