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Rivers provide vital ecosystem services for populations. However, these ecosystems face several anthropogenic threats, including macrolitter pollution, and their impacts remain inadequately understood. This study aimed to evaluate the ecological status of the Leça river (northern Portugal) according to the elements defined by the Water Framework Directive (WFD) and to quantify marginal macrolitter as a new ecological tool for river water quality assessment. Physical, chemical, and biological (photosynthetic pigments; benthic macroinvertebrates) elements were quantified to evaluate the ecological status, of seven sites (P1 to P7) along the Leça river throughout four seasons (autumn/23, winter/24, spring/24, summer/24). Macrolitter was collected on the riverbank of each site and was quantified and categorized according to standard protocols. Based on the physical and chemical elements, Leça river achieved Good ecological status in P1, and Moderate in P4 to P7 (mainly due to nutrient enrichment) with P2 and P3 varying between Good and Moderate. The ecological status according to the macroinvertebrate community varied between: Good and Moderate in P1; Moderate and Poor in P2 and P3; Poor in P4 and P5; and Poor and Bad in P6 and P7. From the 1717 macrolitter items (belonging to 86 categories), artificial polymer/plastic items were the most frequent (56.67 %). More abundance and diversity of items were collected in sites P3 to P7, coinciding with the increasing anthropic presence. A multivariate analysis revealed that items originating from recreational activities were associated with fewer alterations in the macroinvertebrate community, while items originating from the deposition of domestic, industrial, and commercial residues were associated with more degraded conditions. The results suggest that the evaluation of macrolitter can be used to indicate anthropogenic activities that threaten aquatic ecosystems.