Plastic has infiltrated every ecosystem on the planet, making encounters between this anthropogenic pollutant and fauna inevitable. Abiotic environmental breakdown involving light, oxygen, temperature and mechanical forces is well-characterized, while biotic degradation mechanisms are less well-understood. Reports of the role of macrofauna in the fragmentation of plastic debris are increasing. This review explores the driving factors for macrofaunal fragmentation, as well as the physiological mechanisms by which plastic items are fragmented. The presence, and access to plastic within an organism’s habitat are the key determinants of macrofaunal plastic degradation. Foraging strategies, along with burrowing and nesting behaviors increase the likelihood of macrofauna interacting with plastics. Though this type of fragmentation can occur externally, it often follows ingestion, which in itself can be driven by resemblance to food. Four physical mechanisms of macrofaunal plastic fragmentation were identified, namely biting, drilling, grazing and grinding. Biting, restricted to the mouthparts of an organism, was the most common form of macrofaunal fragmentation reported in literature. Similarly, the use of specialized mouthparts for drilling or grazing can produce secondary plastic particles. Lastly, grinding, through manipulation by the gizzard or gastric mill following ingestion can significantly reduce the size of the plastic material. Prolonged and/or repeated interactions with plastics pose the risk of increased wear on the mouthparts and digestive organs involved. Through mechanisms that directly affect the plastic’s structural integrity, physical fragmentation by macrofauna can amplify overall plastic degradation rates and the formation of micro- and nanoplastics in the environment, while long internal retention times can contribute to their dispersal, trophic transfer, and the organism’s exposure to plastic additives. To more fully understand the extent of macrofaunal plastic fragmentation and allow predictive modeling, we suggest the reporting of evidence in a unified and systematic way. Our findings further highlight the urgency for the implementation of a global plastic waste management system to reduce the burden of micro- and nanoplastics.