Objectives of the present study are to provide quantitative estimations of air pollution health impacts and monetary burden on people living in Agra city, the fourth most populated city in Uttar Pradesh, India. To estimate the direct health impacts of air pollution in Agra city during year 2002 to 2014, ‘Risk of Mortality/Morbidity due to Air Pollution’ model was used which is adopted from air quality health impact assessment software, developed by world health organization (WHO). Concentrations of NO2, SO2 and PM10 have been used to assess human health impacts in terms of attributable proportion of the health outcome as- annual number of excess cases of total mortality, cardiovascular mortality, respiratory mortality, hospital admission chronic obstructive pulmonary disease (COPD), hospital admission respiratory disease and hospital admission cardiovascular disease and it was observed that attributable number of cases were 1325, 908, 155, 138, 1230 and 348 respectively in year 2002. However, after thirteen years these figures increased to 1607, 1095, 189, 167, 1568 and 394 respectively. From these results, it was observed that from 2002 to 2014, the attributable number of cases increased almost by 13.43 to 27.52%. As a result, the monetary cost burden due to air pollution related health effects also increased very highly; it was 67.99 million US$ in 2002, which transformed into 254.52 million US$ in 2014. In future, if air quality continues to follow current pollutant concentration trend, the monetary cost burden will reach a level of US$ 570.12 million in year 2020, which is not only a thoughtful matter but also a threatful matter and it signifies the importance of rectification measures for air quality in Agra city.