Air pollution (AP) is still responsible for 40,000 deaths annually in France. The main objective of this study was to characterize trends in urban air pollution and its impact on mortality by comparing the periods 2008–2010 and 2017–2019 in the Toulouse area. The study also aimed to assess the potential health benefits if concentrations of pollutants considered as tracers had complied with the World Health Organization’s (WHO) 2021 guideline values during the 2017–2019 period. The distribution of this health impact according to social deprivation and an exploration of the associated economic impacts were also estimated. Several quantitative health impact studies (EQIS) were thus conducted by modeling population exposure to PM2.5 and NO2 within the territory covered by Toulouse’s second Air Protection Plan (PPA). The French European Deprivation Index (French EDI) was used as a fine-scale indicator of social deprivation, and economic impacts were estimated by assigning a monetary value to the prevention of a death. Across the entire PPA zone, annual concentration averages decreased from 17.2 μg/m³ to 10.3 μg/m³ for PM2.5 and from 21.7 μg/m³ to 18.1 μg/m³ for NO₂, between 2009 and 2019. The proportion of all-cause mortality attributable to air pollution (95% confidence interval [95% CI]) therefore decreased from 15.7% [5.8; 23.8] to 7.2% [2.6; 11.2] for PM2.5 between 2009 and 2019; it decreased from 2.7% [0.9; 4.2] to 1.9% [0.7; 2.9] for NO₂ over the same period. Despite this improvement, concentrations of tracer pollutants remain above the 2021 WHO guideline values, and 440 deaths attributable to overexposure to PM2.5 could still have been prevented each year if these values had already been met in 2019. A weak but increasing gradient of PA exposure is also observed from the least disadvantaged population quintile to the most disadvantaged quintile. This leads to an even more pronounced increasing gradient of PA-attributable mortality between these quintiles, and this gradient widened between 2009 and 2019. The annual economic gains that could potentially have been observed if the 2021 WHO guidelines had already been met were estimated at 2,772 million euros (2018) in 2009 and 1,423 million euros (2018) in 2019.