Population 100K+ · Ranked by Median AQI (Worst First) · Data updated April 2026

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 27 F 90 7% 389 4,559,748
02 Riverside County CA 34 F 82 11% 378 2,478,600
03 San Bernardino County CA 67 F 78 8% 394 2,197,104
04 Kern County CA 47 F 78 15% 320 915,075
05 Tulare County CA 55 F 76 18% 330 478,693
06 Los Angeles County CA 9 F 73 6% 278 9,808,667
07 Fresno County CA 36 D 68 22% 210 1,016,725
08 San Diego County CA 9 D 66 14% 86 3,288,774
09 Pinal County AZ 90 D 65 25% 134 469,006
10 Kings County CA 85 D 64 25% 129 153,298
11 Clark County NV 56 D 62 24% 86 2,329,548
12 Bernalillo County NM 74 D 62 22% 58 673,930
13 El Paso County TX 85 D 61 21% 58 870,779
14 Imperial County CA 83 D 61 25% 123 180,202
15 Harris County TX 8 D 61 15% 100 4,838,303
16 Wayne County MI 67 C 59 20% 42 1,772,259
17 Marion County IN 10 C 58 24% 40 975,809
18 Lancaster County PA 77 C 58 27% 29 557,931
19 Salt Lake County UT 70 C 58 34% 92 1,196,523
20 Stanislaus County CA 8 C 57 33% 93 553,990
21 Jefferson County AL 34 C 57 28% 27 667,755
22 Cook County IL 95 C 57 28% 63 5,182,090
23 Allegheny County PA 36 C 56 34% 35 1,238,177
24 Cuyahoga County OH 60 C 56 32% 25 1,245,873
25 Madison County IL 56 C 55 30% 31 264,238
26 Placer County CA 79 C+ 55 41% 80 419,156
27 Madera County CA 50 C+ 55 40% 63 160,940
28 Butler County OH 40 C+ 55 35% 25 392,876
29 Philadelphia County PA 32 C+ 55 34% 29 1,579,706
30 Hamilton County OH 6 C+ 55 33% 28 830,774
31 Missoula County MT 47 C+ 54 39% 53 120,672
32 Tarrant County TX 23 C+ 54 36% 63 2,167,390
33 Pima County AZ 12 C+ 54 33% 34 1,060,490
34 Jefferson County KY 18 C+ 54 37% 29 783,022
35 Bexar County TX 0 C+ 54 36% 37 2,067,341
36 Oklahoma County OK 74 C+ 54 38% 17 806,199
37 Merced County CA 68 C+ 54 43% 61 290,201
38 Lake County IN 61 C+ 54 38% 29 500,379
39 Pulaski County AR 29 C+ 54 36% 8 399,818
40 Denver County CO 12 C+ 54 38% 48 718,877
41 Orange County CA 43 C+ 53 38% 35 3,165,820
42 Weld County CO 11 C+ 53 43% 55 350,396
43 Sacramento County CA 57 C+ 53 45% 67 1,594,006
44 Tulsa County OK 69 C+ 53 41% 40 680,794
45 Fulton County GA 58 C+ 53 42% 19 1,076,561
46 Hinds County MS 18 C+ 53 40% 5 218,533
47 Calcasieu Parish LA 88 C+ 52 44% 6 207,088
48 Jackson County MO 61 C+ 52 42% 7 719,976
49 Duval County FL 40 C+ 52 40% 2 1,023,153
50 Bossier Parish LA 56 C+ 52 45% 1 129,789
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Counties ranked
Cite this ranking

BoomTownIndex, “Worst Air Quality (Large Counties).” Data: April 2026. https://boomtownindex.com/rankings/worst-air-quality/

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