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The environment people live in impacts their health. One major factor associated with environmental health is air quality. Since the implementation of the Clean Air Act, the United States has been making progress to improve air quality with the National Ambient Air Quality Standards (EPA, 2019b). Despite improvements, many studies have found associations between air quality and respiratory diseases like asthma (Sun & Zhu, 2019). Studies reviewing childhood asthma prevalence and air quality, however, have had conflicting results. To better understand this relationship, this study completed a secondary data analysis to determine if there was an association between childhood asthma prevalence and air quality in metropolitan areas in the United States. To complete this study, two datasets were used. Air quality was evaluated using annual air quality index (AQI) data from the EPA. The second dataset was the 2017 Selected Metropolitan/Micropolitan Area Risk Trends Behavioral Risk Factor Surveillance System dataset from the CDC. The datasets were combined based on statistical area codes and analyzed using SAS on Demand for Academics. A bivariate analysis was completed using chi square and two sample t-tests. The final analyses used a mixed-effects logistic regression evaluating three annual AQI measurements while controlling for the adult respondent’s health care coverage and education level. Overall, this study found there was no association between annual AQI and childhood asthma prevalence. There were, however, many limitations to this study. Therefore, additional studies reviewing individual air pollution exposure and childhood asthma prevalence should be performed to better understand this relationship.