Marine litter and non-degradable plastic pollution is of global concern. Regular monitoring programs are being established to assess and understand the scale of this pollution. In Europe, the goal of the European Marine Strategy Framework Directive (MSFD) is to assess trends in Good Environmental Status and support large-scale actions at the regional level. Marine litter monitoring requires tailored sampling strategies, protocols and indicators, that align with specific objectives and are tailored for local or regional needs. In addition, the uneven spatial and temporal distributions of marine litter present a challenge when designing a statistically powerful monitoring program. In this paper, we critically review the existing marine litter monitoring programs in Europe. We discuss the main constraints, including environmental, logistical, scientific, and ethical factors. Additionally, we outline the critical gaps and shortcomings in monitoring MSFD beaches/shorelines, floating litter, seafloor litter, microplastics, and harm. Several priorities must be established to shape the future of monitoring within the MSFD. Recent developments in analytical approaches, including optimizing protocols and sampling strategies, gaining a better understanding of the spatiotemporal heterogeneity of litter and its implications for survey design and replication, and the inclusion of newly validated methodologies that have achieved sufficient technical readiness, must be considered. Although there are well-established methods for assessing beaches, floating and seafloor litter, it will be necessary to implement monitoring schemes for microplastics in sediments and invertebrates as robust analytical methods become available for targeting smaller particle size classes. Furthermore, the inclusion of indicators for entanglement and injury to marine organisms will have to be considered in the near future. Moreover, the following actions will enhance the effectiveness of monitoring efforts: (1) creating an inventory of accumulation areas and sources of specific types of litter (e.g., fishing gear), (2) monitoring riverine inputs of litter, (3) monitoring atmospheric inputs including microplastics, (4) accidental inputs during extreme weather events, and (5) studying how species at risk may be transported by litter. We provide recommendations to support long-term, effective, and well-coordinated marine litter monitoring within the MSFD to achieve a comprehensive and accurate understanding of marine litter in EU waters. This will allow the development of measures to mitigate the impacts of marine pollution and eventually to evaluate the success of the respective measures.