Plastic pollution has become a major environmental and societal concern in the last decade. From larger debris to microplastics (MP), this pollution is ubiquitous and particularly affects aquatic ecosystems. MP can be directly or inadvertently ingested by organisms, transferred along the trophic chain, and sometimes translocated into tissues. However, the impacts of such MP exposure on organisms’ biological functions are yet to be fully understood. Here, we used a multi-diagnostic approach at multiple levels of biological organization (from atoms to organisms) to determine how MP affect the biology of a marine fish, the gilthead seabream, Sparus aurata. We exposed juvenile seabreams for 35 days to spherical 10–20 μm polyethylene primary MP through food (Artemia salina pre-exposed to MP) at a concentration of 5 ± 1 μg of MP per gram of fish per day. MP-exposed fish experienced higher mortality, increased abundance of several brain and liver primary metabolites, hepatic and intestinal histological defects, higher assimilation of an essential element (Zn), and lower assimilation of a nonessential element (Ag). In contrast, growth and muscle C/N isotopic profiles were similar between control and MP-exposed fish, while variable patterns were observed for the intestinal microbiome. This comprehensive analysis of biological responses to MP exposure reveals how MP ingestion can cause negligible to profound effects in a fish species and contributes towards a better understanding of the causal mechanisms of its toxicity.