Heavy metal and microplastic pollutions are prevalent in freshwater ecosystems, with many freshwater bodies being contaminated by one or both of these pollutants. Recent studies reported extreme detections of Cd, Pb and Zn, high concentrations of Cr, Pb and Cu and microplastics acting as vectors of pollutants, including heavy metals. Mayflies can serve as bioindicators of heavy metal contamination in freshwater ecosystems because changes in their community structure, physiology, and behaviour can reflect and help predict the concentrations of metals in these environments. This review discusses the ecological alterations induced by tissue metal concentration in mayflies and other macroinvertebrates. As sensitive taxa to heavy metal contamination, mayflies can reflect the impacts of this pollution through their ethology and relationship to the substrate, highlighting issues such as eutrophication, alterations in community structure, inhibitory effects and sediment toxicity. Mayflies are also highly affected by microplastic exposure, which leads to ingestion, bioaccumulation, biomagnification, habitat and community alteration, behavioural changes, physiology alteration and toxicity. Mayflies bioindication metrics for assessing the impact of heavy metals and microplastics include the examination of community alteration, functional feeding behaviour, molecular structure, dietary and toxicity impacts, bioaccumulation and biomagnification and biomarkers. Current challenges for the utilization of mayflies as bioindicators include temporal variations in sensitivity, lack of universally recognised protocols and need for standardised protocols for microplastic analysis. Additionally, the applicability of mayflies as bioindicators may vary across different ecosystems, emphasising the need for selecting suitable indicators that align with the unique characteristics of the ecosystem.