Ultrafine particles (UfPs, PM<0.1) are constituents of urban ambient air aerosol. We have reviewed literature on UfPs in urban ambient air and their health perspectives. Generally traffic-linked and of anthropogenic origin, these are toxicants and a health risk factor for urban subjects. UfPs occur in single and agglomerate forms. Studies on the number concentrations of UfPs show tens of thousand times greater levels in urban aerosol than in nonurban aerosol. These nanosize pollutants seem to have more aggressive implications than other respirable fractions of urban aerosol. In literature, it is hypothesized that a chronic exposure to their high number concentrations and their vast surface area, transporting various toxicants, injure tissues or cells and induce inflammation or, eventually, adverse health effects. UfPs are deposited deep in the tissues, translocate, and skip the innate clearance mechanisms. After retention for a long time, these can infiltrate into the interstitium and permeate cells. Traffic-linked UfPs have been found to be toxic to the respiratory, cardiovascular, and nervous systems. At the molecular level, UfPs influence signaling cascade, actin-cytoskeleton pathway, immunoregulation, reactive oxygen species generation to trigger histaminic response, mast cell activation, and pro-inflammatory changes; their mutagenic and carcinogenic effects are also tacit in view of the carcinogenic potential of diesel exhaust in humans. The molecular changes are proposed to be the subclinical effects that manifest disease exacerbations or the predisposition of subjects to pathologies after exposure to UfP. A legislatively regulated monitoring of UfP-contaminated urban ambient air environment is also endorsed to reduce the disease load or its exacerbation that is growing in diesel exhaust (a human carcinogen)-polluted urban areas.