Evidence suggests that air pollution, specifically the particulate matters PM2.5 and PM10, plays a key role in exacerbating the risk of prolonged symptoms following COVID-19 infection. Aim: This study endeavors to elucidate the potential interaction between chronic air pollution exposure and the manifestation of long COVID symptoms within a cohort based in Makkah, Saudi Arabia. Methods: Participants included residents from the Makkah region who had recovered from COVID-19 between 2022 and 2023. A comprehensive questionnaire was utilized to gather detailed demographic data and assess the persistent symptoms seen during the post-COVID period. To gauge the environmental exposure to potential risk factors, air sampling for PM10 and PM2.5 was systematically conducted in various locations in Makkah over a year. Results: Significant positive associations were found between PM2.5 and PM10 exposure and long COVID. Furthermore, specific symptom analysis revealed a significant association between air pollution and shortness of breath (for PM2.5). Only PM2.5 exposure remained statistically significant (RR = 1.32, 95% CI: 1.05, 1.67). In contrast, the association with PM10 remained on the cusp of significance, with an RR of 1.27 (95% CI: 1.00, 1.61). Conclusion: This study highlights the importance of reducing air pollution levels to mitigate the long-term health consequences of COVID-19.