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National estimates of the health and economic burdens of exposure to ambient fine particulate matter (PM_2.5) in India reveal substantial impacts. This information, often lacking at the local level, can justify and drive mitigation interventions. Here, we assess the health and economic gains resulting from attainment of WHO guidelines for PM_2.5 concentrations – including interim target 2 (IT-2), interim target 3 (IT-3), and the WHO air quality guideline (AQG) – in Nagpur district to inform policy decision making for mitigation. We conducted a detailed assessment of concentrations of PM_2.5 in 9 areas, covering urban, peri-urban and rural environments, from February 2013 to June 2014. We used a combination of hazard and survival analyses based on the life table method to calculate attributed annual number of premature deaths and disability-adjusted life years (DALYs) for five health outcomes linked to PM_2.5 exposure …