The impact of major gaseous and particulate pollutants emitted by the wildfire of October 2003 on ambient air quality and health of San Diego residents before, during, and after the fire are analyzed using data available from the San Diego County Air Pollution Control District and California Air Resources Board. It was found that fine particulate matter (PM) levels exceeded the federal daily 24-hr average standard during the fire. There was a slight increase in some of the gaseous pollutants, such as carbon monoxide, which exceeded federal standards. Ozone (O3) precursors, such as total hydrocarbons and methane gases, experienced elevated concentration during the fire. Fortunately, the absence of sunlight because of the cloud of thick smoke that covered most of the county during the fire appears to have prevented the photochemical conversion of the precursor gases to harmful concentrations of O3. Statistical analysis of the compiled medical surveillance data has been used to establish correlations between pollutant levels in the region and the resultant health problems experienced by the county citizens. The study shows that the increased PM concentration above the federal standard resulted in a significant increase in hospital emergency room visits for asthma, respiratory problems, eye irritation, and smoke inhalation. On the basis of the findings, it is recommended that hospitals and emergency medical facilities engage in pre-event planning that would ensure a rapid response to an impact on the healthcare system as a result of a large wildfire and appropriate agencies engage in the use of all available meteorological forecasting resources, including real-time satellite imaging assets, to accurately forecast air quality and assist firefighting efforts.