Air pollution is a significant global issue that affects human well-being. This study investigated the knowledge and perception of air pollution among the population in Makkah, Saudi Arabia. A survey was conducted in Makkah between December 2023 and April 2024 to investigate public knowledge and perception about air pollution and its impact on adverse health effects. The study population consisted of patients admitted to hospitals in Makkah. A total of 1022 respondents, aged between 15 and 66 years, completed an online standardized questionnaire. Questions related to demographic characteristics, including age and gender, were also included in the questionnaire. The findings demonstrated increased concern over air pollution as the majority of respondents, 77% (787), considered air pollution a significant environmental health issue in Makkah. Natural dust was identified as the main source of air pollution in Makkah among 51% (211) men and 45% (268) women, followed by transportation, as reported by 36% (215) women and 34% (143) men. Fifty-one percent (296) of respondents aged above 36 years believed that air pollution could impact their health compared to 49% (216) of the study subjects aged between 15 and 35 years. The most common health effect reported by the respondents associated with exposure to air pollution was bronchitis 41% (419), followed by asthma 38% (388), and heart disease 26% (266). The study outcomes show that most of the study respondents have considerable knowledge about air pollution and perceive air quality as a significant health concern. Implementing sustainable strategies and comprehensive awareness campaigns to mitigate health impacts associated with air pollution in Makkah is recommended.Implication statement:As the first study of its kind in Makkah, this research provides crucial baseline data on public perception of air pollution and its health impacts. The findings highlight gaps in awareness and emphasise the need for targeted health education and policy interventions to improve environmental health literacy and reduce exposure risks.