Transitional waters (TWs), such as coastal lagoons, are bodies of surface water at the transition between saline and freshwater domains. These environments play a vital role in guaranteeing ecosystem services, including provision of food, protection against meteorological events, as anthropogenic carbon sinks, and in filtering of pollutants. Due to the escalating overpopulation characterising coastlines worldwide, transitional systems are over-exploited, degraded, and reduced in their macroscopic features. However, information on the impact of anthropogenic pressures on planktonic organisms in these systems is still scanty and fragmented. Herein, we summarise the literature, with a special focus on coastal lagoons undergoing anthropogenic pressure. Specifically, we report on the implications of human impacts on the ecological state of plankton, i.e., a fundamental ecological component of aquatic ecosystems. Literature information indicates that human forces may alter ecosystem structures and functions in coastal lagoons, as in other TWs such as estuaries, hampering the phytoplankton–zooplankton link, i.e., the main trophic process occurring in those communities, and which sustains aquatic productivity. Changes in the dominance and lifestyle of key planktonic players, plus the invasion of ‘alien’ species, and consequent regime shifts, are among the most common outcomes of human disturbance.