<p>This study assessed air pollutant levels (O₃, PM₁₀ and PM_2.5) in the Metropolitan Area of Porto Alegre, Brazil, from 2002 to 2021, focusing on the impact of PM₁₀ on all-cause mortality for non-accidental causes in individuals over 30-years old. It also examined the health and economic benefits associated with the reduction of PM₁₀ and O₃ in simulated scenarios, considering the number of hospitalizations for respiratory and cardiovascular diseases. Overall, PM₁₀ and PM_2.5 levels decreased by 45.7% and 45.6%, respectively, at a rate of 3.2% per year. In contrast, O₃ levels increased by 478.9% compared to the initial period, with a peak in 2012, followed by a 64.6% decrease from that maximum and an overall increase rate of 9.8% per year. Deaths attributed to PM₁₀ exposure declined by over 50% in the second decade of the study, reflecting the trend in this pollutant concentration. Simulated scenarios of O₃ and PM₁₀ reduction demonstrated benefits in terms of prevented hospitalizations for respiratory and cardiovascular diseases, yielding economic savings exceeding 15 million Brazilian reais during the study period. The air pollution trends in the Metropolitan Area of Porto Alegre follow a global pattern, emphasizing the need for continued efforts to reduce air pollution levels and improve health indicators, such as reductions in hospitalizations for respiratory and cardiovascular diseases, decreases in mortality attributed to air pollution, and alleviation of the economic burden on healthcare systems.</p>