This study evaluates spatiotemporal variation of particulate pollution and associated health impacts in Jodhpur, an arid Indian city among the most polluted in the country. Data from nine monitoring stations (2019-2024) were analyzed for PM2.5 and PM10 using meteorological parameters, geospatial mapping, and the Air Quality Index (AQI). Health risks were quantified with the WHO-recommended AirQ+ model for both long-term (LTEs) and short-term exposures (STEs). Results indicate that city-averaged PM2.5 concentrations declined from 100.9 & micro;g/m3 in 2019 to 53.5 & micro;g/m3 in 2024 (47%), while PM10 decreased from 213.0 to 135.6 & micro;g/m3 (36%). Seasonal patterns remained distinct, with premonsoon and winter peaks influenced by boundary-layer dynamics, wind regimes, and monsoonal washout. Spatial analysis identified persistent hotspots in residential (S-2) and traffic-dense (S-9) zones, while S-6 showed the largest relative improvement. The AQI improved from poor (273) in April 2019 to good (50) in August 2024. PM2.5-attributable all-cause and lung cancer mortality declined by 47% and 44%, respectively, alongside 69% reductions in asthma and cardiovascular hospitalizations. Despite these gains, persistent hotspots necessitate stricter emission control and seasonally adaptive strategies for sustainable urban air quality management in arid regions. Key points City-wide PM2.5 and PM10 concentrations in Jodhpur declined by 47% and 36% during 2019-2024, indicating sustained improvement in air quality beyond short-term lockdown effects.Seasonal patterns persisted, with premonsoon and winter peaks driven by dust resuspension and boundary-layer dynamics, while monsoon rainfall consistently produced the lowest particulate levels.Spatial analysis revealed persistent pollution hotspots in traffic- and industrial-dense zones, closely linked to bare land, land-use change, and land surface temperature variations.Health risk assessment showed major public health benefits, including about 47% reduction in PM2.5-attributable all-cause mortality and 69% declines in respiratory and cardiovascular hospitalizations.