Historically, California has been a world leader in the development and application of environmental regulations. Policies to address air pollution have reduced criteria pollutant emissions, improved regional air quality, and benefited public health. To this end, California has imposed strict regulations on light-duty, medium-duty, and heavy-duty vehicles to reduce ambient concentrations of health-damaging pollutants such as ozone and fine particulate matter (PM2.5). Here, we compare the impact on air quality in California should California not have adopted on-road vehicle regulations (No Regulations Case) with the air quality associated with current regulations (Regulated Case). Simulations of atmospheric chemistry and transport are conducted to evaluate the impact of emissions on ambient levels of ozone and PM2.5, and a health impact assessment tool is used to quantify and monetize societal impairment. Compared with the "Regulated Case," the "No Regulations Case" results in a maximum peak 8 h ozone level of 162 ppb and 24 h PM2.5 of 42.7 μg/m3 in summer, and 107 μg/m3 and 24 h PM2.5 in winter. The associated increases in the daily incidence of human health outcomes are $66 million per day and $116 million per day during peak pollutant formation periods in summer and winter, respectively. Overall, the findings quantitatively establish the role and importance of on-road vehicle regulations in protecting societal well-being.