This study aimed to assess public perceptions and practices regarding air quality and its impact on respiratory health in Saudi Arabia. A cross-sectional survey was conducted among 539 participants, selected through stratified random sampling across urban, semi-urban, and rural areas. Data were collected via an online questionnaire and analyzed using descriptive statistics, t-tests, and ANOVA. Findings indicated that 63.2% (n = 341) of participants occasionally checked air quality reports, with moderate confidence in interpreting them (52.5%, n = 283). Awareness of the health impacts of air pollution was higher in urban areas, while rural participants showed less concern and lower awareness (P < .0001). Younger participants (18-30 years) had the highest concern about air pollution (mean: 3.39), whereas older participants demonstrated lower awareness of associated health risks (P < .0001). The study found no significant gender differences in perceptions (P > .05). Despite moderate concern about air pollution, participants perceived a low impact on their quality of life (mean: 2.85). The study underscores the importance of localized public health strategies to address air quality concerns and mitigate respiratory health risks in Saudi Arabia.