From 2013 to 2017, China implemented stringent clean air policies, leading to significant reductions in PM2.5 concentrations nationwide. This study quantifies the drivers of improved PM2.5 air quality and associated health benefits using an integrated approach combining emission inventories, chemical transport models, and epidemiological data. National PM2.5 concentrations decreased from 61.8 to 42.0 µg/m³, with major contributions from anthropogenic emission reductions. Meteorological factors had limited impact on long-term trends. Key measures included strengthening industrial emission standards, upgrading industrial boilers, phasing out outdated capacities, and promoting clean fuels in the residential sector. These measures reduced PM2.5 concentrations by 6.6–2.2 µg/m³ and prevented 0.37 million excess deaths. The study highlights the effectiveness of China's clean air actions and provides insights for future policies in China and other developing countries. The results emphasize the importance of industrial emission controls and the need for continued efforts to address remaining pollution challenges.From 2013 to 2017, China implemented stringent clean air policies, leading to significant reductions in PM2.5 concentrations nationwide. This study quantifies the drivers of improved PM2.5 air quality and associated health benefits using an integrated approach combining emission inventories, chemical transport models, and epidemiological data. National PM2.5 concentrations decreased from 61.8 to 42.0 µg/m³, with major contributions from anthropogenic emission reductions. Meteorological factors had limited impact on long-term trends. Key measures included strengthening industrial emission standards, upgrading industrial boilers, phasing out outdated capacities, and promoting clean fuels in the residential sector. These measures reduced PM2.5 concentrations by 6.6–2.2 µg/m³ and prevented 0.37 million excess deaths. The study highlights the effectiveness of China's clean air actions and provides insights for future policies in China and other developing countries. The results emphasize the importance of industrial emission controls and the need for continued efforts to address remaining pollution challenges.