Microplastics (MPs) could serve as vectors of antibiotics and heavy metals through sorption and desorption. However, the combined adsorption process of antibiotics and heavy metals on aged MPs has rarely been studied. In this study, combined adsorption/desorption of tetracycline (TC) and Cd(II) on/from polystyrene (PS) and polyethylene terephthalate (PET) MPs, as well as ultraviolet (UV) and H2O2 aged MPs, was investigated. The specific surface areas of the MPs increased after UV and H2O2 aging. Adsorption experiments showed that the pseudo-second-order kinetic model and Freundlich model fitted adsorption of TC and Cd(II) on all of the MPs. The adsorption capacities of TC and Cd(II) were higher on aged MPs than on the pristine MPs, especially on H2O2 treated MPs. TC adsorption on the MPs was hardly affected by Cd(II), and Cd(II) adsorption was not significantly affected by TC when the solution pH value was below 8.0. Cd(II) slightly enhanced TC adsorption on the MPs at pH 8.0, especially on the aged MPs. The TC adsorption capacities increased with increasing pH, reaching a maximum at pH 5.0 or 6.0, and they then decreased, while the largest level of Cd(II) adsorption was at approximately pH 6.0. Adsorption of TC and Cd(II) on the pristine and aged MPs was thermodynamically favorable and spontaneous. The trend of the desorption rates of TC and Cd(II) from the MPs in different background solutions was ultrapure water < surface water < simulated gastric fluid. The desorption rates of TC and Cd(II) from the aged MPs were lower than those from the pristine MPs. The results revealed the mechanism of the TC and Cd(II) combined adsorption process on aged MPs, which will provide insight for understanding the aging process and its potential effects on sorption and desorption of antibiotics and heavy metals in the real environment.