Although there are vehicular emissions control programs, vehicles that violate ongoing standards of these programs threaten both environment and health on developing countries urban centers. This study aimed to evaluate air quality and public health impacts due to emissions from vehicles that violate Brazilian emissions standards in Sao Paulo Metropolitan Area. We analyzed particulate matter emissions on 2014–2015 biennium. We projected scenarios in which all circulating vehicles were according to Brazilian vehicular emission control standards and estimated the emissions’ reduction using the bottom-up method. We considered a proportional reduction in pollutant concentration equivalent to the percentage reduction in emissions. The years of life lost avoided due to cardiopulmonary problems were estimated considering the impacted population fraction by air quality improvement. Results indicated that the substitution of vehicles which violate Brazilian standards by more modern models would improve 33% PM₁₀ and 17% PM_2.5 air quality and avoid 65,568 years of life lost, which, considering the life year value, is US$ 4bi equivalent. This study reinforces the need of an Accelerated Vehicle Retirement Program implementation and mostly cleaner transportation investments.