<p>Thessaloniki is the second largest city in Greece with air quality problems that led to a fine by the European Union in 2023. This study explored perception and awareness of air pollution among citizens and its impact on their everyday lives. The results showed that half of the respondents (50.2%) rated air quality in the city as “bad”, 40% considered it “average” and only about 10% described it as “good”. Perceptions were not significantly affected by gender, age, education, time spent outdoors while at work, smoking, transportation mode or having or knowing someone who has respiratory or heart disease. Locality partly played a role. Exercising outdoors, however, did affect perception. About half of the respondents were unaware of PM pollutants and their impact on health. Gender, education and age affected awareness. About 70% of the participants did not know who is responsible for monitoring air pollution data and where to access this information. Around 56% of respondents did not know that Greece had been fined by the European Court for failing to meet air quality standards in Thessaloniki. Around 90% expressed some level of anxiety because of air pollution and anxiety was correlated with increased age but not gender or education. All commuters expressed annoyance at traffic-related air pollution, with cyclists being annoyed the most and car drivers the least. Around 42% of those who exercise outdoors said that air pollution affects their exercise schedule. These findings highlight the need to increase awareness and include air pollution effects in urban and health planning.</p>