Abstract With rapid economic growth, China has witnessed increasingly frequent and severe haze and smog episodes over the past decade, posing serious health impacts to the Chinese population, especially those in densely populated city clusters. Quantification of the spatial and temporal variation of health impacts attributable to ambient fine particulate matter (PM2.5) has important implications for China's policies on air pollution control. In this study, we evaluated the spatial distribution of premature deaths in China between 2000 and 2010 attributable to ambient PM2.5 in accord with the Global Burden of Disease based on a high resolution population density map of China, satellite retrieved PM2.5 concentrations, and provincial health data. Our results suggest that China's anthropogenic ambient PM2.5 led to 1,255,400 premature deaths in 2010, 42% higher than the level in 2000. Besides increased PM2.5 concentration, rapid urbanization has attracted large population migration into the more developed eastern coastal urban areas, intensifying the overall health impact. In addition, our analysis implies that health burdens were exacerbated in some developing inner provinces with high population density (e.g. Henan, Anhui, Sichuan) because of the relocation of more polluting and resource-intensive industries into these regions. In order to avoid such national level environmental inequities, China's regulations on PM2.5 should not be loosened in inner provinces. Furthermore policies should create incentive mechanisms that can promote transfer of advanced production and emissions control technologies from the coastal regions to the interior regions.