Background - With jurisdiction over air quality since January 1, 2015, Bordeaux Métropole sought up-to-date data on the estimated health effects of air pollution and asked the Nouvelle-Aquitaine Regional Health Observatory to assist them in conducting a quantitative assessment of the health impact of air pollution (EQIS-PA). Methods - The EQIS-PA was conducted based on the recommendations of the Santé publique France EQIS guide on ambient air pollution. Health impacts (short-term effects of concentrations of fine particulate matter with a diameter of less than 10 μm (PM10) and nitrogen dioxide (NO2), and chronic exposure to fine particulate matter with a diameter of less than 2.5 μm (PM2.5)) were calculated for the 2013–2015 period using the AirQ+ software®. Results - Over the 2013–2015 period, PM2.5 concentration levels were 13.4 μg/m³, and the burden of air pollution was estimated at approximately 600 deaths per year within Bordeaux Métropole, representing 11.2% of total mortality. A 30% reduction in the annual average PM2.5 concentration observed over the 2013–2015 period (i.e., a concentration reaching the level measured in 2019) would prevent approximately 300 deaths per year in the long term. A similar reduction in NO2 would have prevented nearly 40 deaths per year. Conclusion - Despite improvements in air quality in recent years, these results provide the local authority with an updated estimate of the health impact of air pollution within its jurisdiction. It follows that air pollution remains a significant risk factor in the Bordeaux metropolitan area, and that efforts to reduce air pollution must continue across all sources. Furthermore, comparing pollution reduction scenarios with the levels measured in 2019 allows for an estimation of the health benefits of improved air quality.