Air pollution has become one of the major risks to human health because of the progressive increase in the use of vehicles powered by fossil fuels. While the risks of air pollution to health were thought to have been brought under control by the Clean Air Acts of the 1950s and 1960s, the situation of air pollution in the UK has now deteriorated to a point where it is contributing to 40,000 excess deaths each year. Here the findings of the RCP/RCPCH’s 2015/16 Working Party on Air Pollution and Health are described and what actions now need to be taken. The UK needs to take a lead and introduce a new Clean Air Act that deals with the vehicle sources of pollution recognising that the toxic particles and gases emitted are effecting individuals from conception to death. This mandates urgent action by government both central and local, but also by all of us who have now become so dependent on road transport.