Plastic debris is the most common and exponentially increasing human pollutant in the world's ocean. The distribution and impact of plastic in the Pacific and Atlantic oceans have been the subject of many publications but not so the Indian Ocean (IO). Some of the IO rim countries have the highest population densities globally and mismanagement of plastic waste is of concern in many of these rim states. Some of the most plastic-polluted rivers empty into the IO, with all this suggesting that the IO receives a tremendous amount of plastic debris each year. However, the concentration, distribution, and impacts of plastics in the IO are poorly understood as the region is under-sampled compared to other oceans. In this review, we discuss sources and sinks, which are specific to the IO. We also discuss unique atmospheric, oceanographic, and topographic features of the IO that control plastic distribution, such as reversing wind directions due to the monsoon, fronts, and upwelling regions. We identify hotspots of possible plastic accumulation in the IO, which differ between the two hemispheres. In the southern IO, plastics accumulate in a garbage patch in the subtropical gyre. However, this garbage patch is not well defined, and plastics may leak into the southern Atlantic or the Pacific Ocean. There is no subtropical gyre and associated garbage in the northern IO due to the presence of landmasses. Instead, the majority of buoyant plastics most likely end up on coastlines. Finally, we identify the vast knowledge gaps concerning plastics in the IO and point to the most pressing topics for future investigation.