Purpose of Review The last five years have witnessed an explosion in interest regarding cardiac arrhythmias and air pollution. The data have been strongest with respect to ventricular arrhythmias but there is accumulating evidence that air pollution is also associated with supraventricular arrhythmias. Recent Findings There is clear epidemiological evidence linking air pollution and cardiac mortality. Whether the cardiac mortality was from myocardial ischemia, congestive heart failure or arrhythmic, or all of these pathways is not clear from the epidemiological data. There is a large body of evidence that air pollution can modify autonomic tone. More recent data, utilizing patients with cardiac disease and implantable cardioverter defibrillators (ICDs) has clarified the association of air pollution and arrhythmias. Data is also accumulating that air pollution may be associated with atrial arrhythmias.