The crisis facing the world’s oceans from plastics is well documented, yet there is little knowledge of the perspectives, experiences and options of the coastal communities facing overwhelming quantities of plastics on their beaches and in their fishing waters. In emerging economies such as those in the Coral Triangle, the communities affected are among the poorest of their countries. To understand the consequences of ocean plastic pollution in coastal regions, through the eyes of local people, this study examines the knowledge, use, disposal and local consequences of single use plastics in remote island communities in two archipelagos of southern Sulawesi, Indonesia. Using mixed methods—a survey of plastic literacy and behaviour, household interviews about purchasing and disposal, and focus group discussions to generate shared mental models—we identify a complex set of factors contributing to extensive plastic leakage into the marine environment. The rising standard of living has allowed people in low resource, remote communities to buy more single-use plastic items than they could before. Meanwhile complex geography and minimal collection services make waste management a difficult issue, and leave the communities themselves to shoulder the impacts of the ocean plastic crisis. Although plastic literacy is low, there is little the coastal communities can do unless presented with better choice architecture both on the supply side and in disposal options. Our results suggest that for such coastal communities improved waste disposal is urgent. Responsible supply chains and non-plastic alternatives are needed. Producers and manufacturers can no longer focus only on low-cost packaged products, without taking responsibility for the outcomes. Without access to biodegradable, environmentally friendly products, and a circular plastic system, coastal communities and surrounding marine ecosystems will continue to be inundated in plastic waste.