Ambient fine particulate matter (PM2.5) is among the leading environmental causes of premature death, and the highest population-weighted exposures now sit in rapidly urbanizing cities of sub-Saharan Africa. Ouagadougou combines heavy two-wheeler traffic, household biomass use, unpaved road dust, and recurrent Harmattan dust, yet the resulting health and economic losses have not been quantified. We estimate the mortality, disability, and economic costs attributable to ambient PM2.5 exposure in Ouagadougou, and we evaluate the benefits of meeting World Health Organization (WHO) air-quality targets. Annual PM2.5 concentrations were compiled from ground monitoring and satellite-derived datasets. Disease-specific relative risks came from the integrated exposure response (IER) functions used by the Global Burden of Disease (GBD) study. We computed population attributable fractions, attributable deaths, years of life lost (YLL), years lived with disability (YLD), and disability-adjusted life years (DALYs) for the five PM2.5-related causes. Economic losses were valued with a cost-of-illness (COI) approach and a benefit-transferred value of a statistical life (VSL). A 10,000-iteration Monte Carlo simulation propagated parameter uncertainty. At a city mean of about 48 μg？m？3, roughly ten times the WHO guideline, ambient PM2.5 was associated with approximately 980 deaths per year (95% CI: 660 to 1420) and 27,900 DALYs (95% CI: 19,000 to 40,000). Lower respiratory infection and stroke carried the largest share. The combined economic loss reached about US$102 million in 2024 values, near 1.8% of the metropolitan product. Meeting the WHO guideline would avoid close to 930 deaths each year. The avoidable burden is large relative to the size of the local economy. Cleaner two-wheeler fleets, a shift away from solid cooking fuels, and dust control on unpaved roads would return measurable health and economic value, and the estimates here give policy a defensible starting point.
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