AbstractAnthropogenic emissions and ambient fine particulate matter (PM_2.5) concentrations have declined in recent years across China. However, PM_2.5 exposure remains high, ozone (O₃) exposure is increasing, and the public health impacts are substantial. We used emulators to explore how emission changes (averaged per sector over all species) have contributed to changes in air quality and public health in China over 2010–2020. We show that PM_2.5 exposure peaked in 2012 at 52.8 μg m⁻³, with contributions of 31% from industry and 22% from residential emissions. In 2020, PM_2.5 exposure declined by 36% to 33.5 μg m⁻³, where the contributions from industry and residential sources reduced to 15% and 17%, respectively. The PM_2.5 disease burden decreased by only 9% over 2012 where the contributions from industry and residential sources reduced to 15% and 17%, respectively 2020, partly due to an aging population with greater susceptibility to air pollution. Most of the reduction in PM_2.5 exposure and associated public health benefits occurred due to reductions in industrial (58%) and residential (29%) emissions. Reducing national PM_2.5 exposure below the World Health Organization Interim Target 2 (25 μg m⁻³) would require a further 80% reduction in residential and industrial emissions, highlighting the challenges that remain to improve air quality in China.