Population 100K+ · Ranked by Median AQI (Worst First)

Worst Air Quality (Large Counties)

Among counties with populations over 100,000, these have the worst air quality based on EPA monitoring data. Grades based on 3-year average median Air Quality Index (2021–2023). Higher AQI means more pollution.

Worst Air Quality (Large Counties)

California's Central Valley Chokes on Poor Air

California dominates this list, with 15 counties, and the Central Valley is a clear hotspot for poor air quality. Counties like Kern (#4), Tulare (#5), and Fresno (#7) are particularly impacted by a combination of agricultural emissions, industrial activity, and geographic features that trap pollutants. The valley's bowl-like topography and frequent inversions create a persistent smog problem, exacerbated by vehicle exhaust from major transportation corridors.

Phoenix's Smog Surprise

Maricopa County, AZ, home to Phoenix, takes the top spot, which might surprise some given its desert reputation. While often associated with clear skies, rapid urban expansion, heavy vehicle traffic, and a hot, dry climate contribute significantly to ozone formation and particulate matter. The surrounding mountains can also trap pollutants, leading to surprisingly persistent poor air quality in this booming metropolitan area.

The Industrial Haze of Pennsylvania

Lancaster County, PA (#18), stands out as an unexpected entry from the Northeast. While not typically thought of as a major pollution hub, its inclusion points to a blend of agricultural emissions, regional industrial activity, and proximity to major transportation routes. This combination, coupled with meteorological conditions that can trap pollutants, contributes to air quality challenges that belie its picturesque reputation.

# County BTI Score Air Grade Median AQI Good Days Unhealthy Days Population
01 Maricopa County AZ 26 F 90 7% 389 4,430,871
02 Riverside County CA 36 F 82 11% 378 2,429,487
03 San Bernardino County CA 63 F 78 8% 394 2,180,563
04 Kern County CA 59 F 78 15% 320 906,883
05 Tulare County CA 68 F 76 18% 330 473,446
06 Los Angeles County CA 13 F 73 6% 278 9,936,690
07 Fresno County CA 56 D 68 22% 210 1,008,280
08 San Diego County CA 13 D 66 14% 86 3,289,701
09 Pinal County AZ 34 D 65 25% 134 433,338
10 Kings County CA 74 D 64 25% 129 152,515
11 Clark County NV 18 D 62 24% 86 2,265,926
12 Bernalillo County NM 33 D 62 22% 58 674,692
13 Imperial County CA 82 D 61 25% 123 179,578
14 El Paso County TX 42 D 61 21% 58 863,832
15 Harris County TX 4 D 61 15% 100 4,726,177
16 Wayne County MI 37 C 59 20% 42 1,781,641
17 Marion County IN 76 C 58 24% 40 971,737
18 Lancaster County PA 66 C 58 27% 29 553,202
19 Salt Lake County UT 26 C 58 34% 92 1,180,643
20 Stanislaus County CA 17 C 57 33% 93 552,063
21 Jefferson County AL 26 C 57 28% 27 672,265
22 Cook County IL 79 C 57 28% 63 5,225,367
23 Allegheny County PA 7 C 56 34% 35 1,245,310
24 Cuyahoga County OH 60 C 56 32% 25 1,256,620
25 Madison County IL 83 C 55 30% 31 265,512
26 Madera County CA 70 C+ 55 40% 63 157,243
27 Hamilton County OH 61 C+ 55 33% 28 827,671
28 Butler County OH 55 C+ 55 35% 25 388,327
29 Placer County CA 35 C+ 55 41% 80 406,608
30 Philadelphia County PA 34 C+ 55 34% 29 1,593,208
31 Missoula County MT 31 C+ 54 39% 53 118,541
32 Pima County AZ 21 C+ 54 33% 34 1,042,393
33 Tarrant County TX 6 C+ 54 36% 63 2,113,854
34 Jefferson County KY 44 C+ 54 37% 29 779,232
35 Bexar County TX 3 C+ 54 36% 37 2,014,059
36 Pulaski County AR 66 C+ 54 36% 8 398,322
37 Lake County IN 63 C+ 54 38% 29 497,682
38 Oklahoma County OK 63 C+ 54 38% 17 795,822
39 Merced County CA 55 C+ 54 43% 61 282,290
40 Denver County CO 6 C+ 54 38% 48 710,800
41 Orange County CA 19 C+ 53 38% 35 3,175,227
42 Weld County CO 9 C+ 53 43% 55 331,466
43 Sacramento County CA 35 C+ 53 45% 67 1,579,211
44 Hinds County MS 96 C+ 53 40% 5 226,541
45 Tulsa County OK 90 C+ 53 41% 40 668,923
46 Fulton County GA 19 C+ 53 42% 19 1,061,944
47 Calcasieu Parish LA 78 C+ 52 44% 6 210,770
48 Jackson County MO 78 C+ 52 42% 7 715,526
49 Duval County FL 21 C+ 52 40% 2 995,708
50 Bossier Parish LA 56 C+ 52 45% 1 128,877