Athletes, due to their high physical activity levels, are particularly susceptible to the impacts of air and water pollution, which can affect multiple physiologic systems over both short- and long-term exposures. This often leads to impaired respiratory function and negative effects on performance. Strategies for understanding pollution patterns, reducing local pollution, and sideline preparedness for specific illnesses are crucial in mitigating these impacts. Additionally, policy changes are being implemented by sports organizations to address these issues and advocate for comprehensive environmental testing and filtering and exposure prevention plans. Educating coaches, trainers, and sports medicine physicians about the effects of air and water quality on performance and health is a growing point of emphasis, brought to the forefront by international committees. In conclusion, the detrimental impacts of air and water pollution on athletes’ health and performance necessitate comprehensive management strategies and policy changes to minimize potential adverse effects.