Arid-region cities experiencing frequent sandstorms are subject to combined exposures to particulate matter and toxic gas-phase pollutants, yet quantitative evidence remains limited on how gas-phase volatile organic compound (VOC) exposure and the associated health-risk structure are reshaped under sandstorm conditions. Here, using high time-resolution observations from a representative sandstorm episode at the Yinchuan Urban Ecosystem Research Station, we integrate USEPA inhalation risk assessment with random-forest modeling to quantify stage-resolved (pre-sandstorm/sandstorm/post-sandstorm) risk evolution and meteorological drivers. The sandstorm period was characterized by a pronounced increase in PM2.5, whereas TVOC decreased from 36.14 & times; 10-9 to 20.76 & times; 10-9 and only partially rebounded across selected components. Despite the overall decline in VOC concentrations, risk contributions shifted toward highly toxic OVOC (acrolein and acetaldehyde) and halogenated compounds (1,2-dichloroethane and naphthalene), with carcinogenic risk exceeding 10-6 for most species and surpassing 10-4 for some. Adults exhibited the highest risk, whereas children showed greater dose sensitivity. Random forest analyses consistently identified atmospheric pressure as the dominant predictor across stages: low-pressure regimes with strong winds primarily reduced risk via enhanced dispersion and dilution, whereas high-pressure and high-humidity conditions further lowered exposure through strengthened deposition and removal. Overall, sandstorms do not simply "clean" the atmosphere in terms of toxicity; instead, they restructure the VOC and particle co-exposure landscape and reorder population risk profiles. These findings provide a scientific basis for targeted control of high-risk VOC species and tiered protection of susceptible groups in arid regions under extreme weather events.