Polyethylene ingestion constitutes a significant health risk for small ruminants, particularly sheep and goats, owing to the ubiquitous nature of plastic pollution in their grazing habitats. This review consolidates empirical evidence indicating that the accumulation of polyethylene within the rumen disrupts normal digestive processes by inducing physical obstruction and hindering microbial fermentation, which culminates in clinical symptoms such as ruminal impaction, indigestion, and decreased nutrient absorption. Such consequences markedly compromise both animal health and productivity. The review additionally assesses integrated management strategies, underscoring the necessity of sustainable waste disposal methodologies, strategic grazing management—including rotational and time-controlled grazing practices—and timely veterinary measures such as the surgical excision of plastic obstructions. The findings underscore that a comprehensive approach, integrating environmental management with clinical care, is imperative to mitigate the risks associated with polyethylene ingestion and safeguard small ruminant populations. Future initiatives should focus on community-driven waste management and the advancement of biodegradable alternatives to alleviate environmental plastic pollution.