Increasing air pollution in South Asia has serious consequences for air quality and human/ecosystem health within the region. South Asia, including India and Nepal, suffers from severe air pollution, including high concentrations of aerosols, as well as gaseous pollutants. One of the often-neglected sources contributing to the regional air pollution is garbage burning. It is mostly related to numerous yet small, open, uncontrolled fires burning diverse fuels, making it difficult to quantify activity and emissions. In this study, we attempted to quantify the total emissions due to garbage burning and its contribution to regional air quality, using new observational data, a new inventory, and a regional chemical transport model. We implemented the newly available emission factors (EFs) from a recent field campaign, Nepal Ambient Monitoring and Source Testing Experiment (NAMaSTE), which took place in April 2015. Using a chemical transport model-Weather Research and Forecasting model coupled with Chemistry version 3.5 (WRF-Chem)-and three emission scenarios, we assessed the impact of open garbage burning emissions on regional air quality. Our results show that garbage burning emissions could increase PM2.5 concentrations by nearly 30% in India and Nepal, and result in ∼300 000 premature deaths from chronic obstructive pulmonary disease in the two countries.