Air pollution in North Macedonia is a big problem, and the country is often one of the most polluted in Europe. The main causes are emissions from factories, car exhaust, and heating systems, especially in winter when coal is used a lot. The country's location, surrounded by mountains, makes the pollution worse by keeping it trapped in the air.

Skopje and other cities have the worst air quality, often going above safe limits for harmful particles and nitrogen dioxide. The main causes are old cars, outdated factories, and heating systems. These release dangerous pollutants like sulfur dioxide, which are bad for people's health.

The health effects are serious, causing lung and heart diseases, and leading to thousands of early deaths each year. Children and older people are at higher risk.

Even though the government knows about the problem, it has done little to fix pollution. Changes to update vehicles, factories, and energy sources have been slow, and public transportation is still not well-developed.

To improve air quality, North Macedonia needs to enforce environmental laws more strictly, invest in clean energy, and encourage the use of greener technologies. Raising public awareness and promoting sustainable practices are also important for protecting people's health.