Long-term exposure to air pollution is associated with increased mortality from cardiovascular and respiratory diseases. This review summarizes epidemiological studies on the effects of fine and coarse particles, nitrogen dioxide (NO₂), and elemental carbon on all-cause, cardiovascular, and respiratory mortality. A meta-analysis of studies found that a 10 μg/m³ increase in PM₂.₅ exposure was linked to a 6% increase in all-cause mortality and an 11% increase in cardiovascular mortality. PM₂.₅ was more strongly associated with cardiovascular mortality than non-malignant respiratory diseases. Significant heterogeneity in effect estimates was observed, likely due to differences in particle composition, indoor particle infiltration, population characteristics, and exposure assessment methods. Elemental carbon and NO₂ were also associated with increased mortality, with pooled estimates of 6% and 5%, respectively. There was little evidence of a stronger association between long-term exposure to coarse particles and mortality. No significant difference in mortality risk was found between men and women. Subjects with lower education and obese individuals had higher mortality risks related to PM₂.₅. The review highlights the need for better exposure assessment, including spatially resolved outdoor exposures and chemically speciated PM, to better understand the heterogeneity in effect estimates. Research is needed to evaluate the effects of air pollution on specific cardiovascular causes of death and respiratory mortality. The review also emphasizes the importance of studying motorized traffic emissions and the need for further research on coarse and ultrafine particles. The findings suggest that long-term exposure to air pollution, particularly PM₂.₅, is a significant risk factor for cardiovascular mortality, while the association with respiratory mortality is less clear. The review concludes that more research is needed to fully understand the health impacts of air pollution and to inform effective policy and intervention strategies.Long-term exposure to air pollution is associated with increased mortality from cardiovascular and respiratory diseases. This review summarizes epidemiological studies on the effects of fine and coarse particles, nitrogen dioxide (NO₂), and elemental carbon on all-cause, cardiovascular, and respiratory mortality. A meta-analysis of studies found that a 10 μg/m³ increase in PM₂.₅ exposure was linked to a 6% increase in all-cause mortality and an 11% increase in cardiovascular mortality. PM₂.₅ was more strongly associated with cardiovascular mortality than non-malignant respiratory diseases. Significant heterogeneity in effect estimates was observed, likely due to differences in particle composition, indoor particle infiltration, population characteristics, and exposure assessment methods. Elemental carbon and NO₂ were also associated with increased mortality, with pooled estimates of 6% and 5%, respectively. There was little evidence of a stronger association between long-term exposure to coarse particles and mortality. No significant difference in mortality risk was found between men and women. Subjects with lower education and obese individuals had higher mortality risks related to PM₂.₅. The review highlights the need for better exposure assessment, including spatially resolved outdoor exposures and chemically speciated PM, to better understand the heterogeneity in effect estimates. Research is needed to evaluate the effects of air pollution on specific cardiovascular causes of death and respiratory mortality. The review also emphasizes the importance of studying motorized traffic emissions and the need for further research on coarse and ultrafine particles. The findings suggest that long-term exposure to air pollution, particularly PM₂.₅, is a significant risk factor for cardiovascular mortality, while the association with respiratory mortality is less clear. The review concludes that more research is needed to fully understand the health impacts of air pollution and to inform effective policy and intervention strategies.