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Abstract Ambient fine particulate matter (PM_2.5) is the world’s leading environmental health risk factor. Quantification is needed of regional contributions to changes in global PM_2.5exposure. Here we interpret satellite-derived PM_2.5estimates over 1998-2019 and find a reversal of previous growth in global PM_2.5air pollution, which is quantitatively attributed to contributions from 13 regions. Global population-weighted (PW) PM_2.5exposure, related to both pollution levels and population size, increased from 1998 (28.3 μg/m³) to a peak in 2011 (38.9 μg/m³) and decreased steadily afterwards (34.7 μg/m³in 2019). Post-2011 change was related to exposure reduction in China and slowed exposure growth in other regions (especially South Asia, the Middle East and Africa). The post-2011 exposure reduction contributes to stagnation of growth in global PM_2.5-attributable mortality and increasing health benefits per µg/m³marginal reduction in exposure, implying increasing urgency and benefits of PM_2.5mitigation with aging population and cleaner air.