Benzene, toluene, ethylbenzene, and xylenes (BTEX) are carcinogenic pollutants. However, the average concentration in 1 h of some pollutants belonging to BTEX, such as benzene, in Ho Chi Minh City (HCMC) is higher than the national standard QCVN 06:2009/BTNMT by about ten times. This research is the first to calculate the emission of BTEX for developing countries on a city scale. This paper developed a method to calculate cold emission factors based on hot emission factors for BTEX. Five spreadsheets developed and calculated these cold emission factors for five vehicle categories. A comprehensive emission inventory (EI) for BTEX was conducted in HCMC to determine the cause of BTEX pollution. An innovative methodology with bottom-up and top-down combination was applied to conduct BTEX EI, in which the EMISENS model was utilized to generate the EI for road traffic sources, and the emission factors method was utilized for other emission sources. Among emission reasons, motorcycles contribute the highest to HCMC air pollution, responsible for 93%, 90%, 98.9%, and 91.5% of benzene, toluene, ethylbenzene, and xylene, respectively. Cars contributed 5%, 6%, 0.8%, and 6.5% of benzene, toluene, ethylbenzene, and xylene, respectively. For LDVs, the emission from benzene, toluene, ethylbenzene, and xylene accounted for 1%, 2%, 0.2%, and 1.9%. The major reasons for point sources were metal production, which had 1%, 2%, and 0.1% for benzene, toluene, ethylbenzene, and xylenes emissions. The area source had a minority emission of total BTEX in Ho Chi Minh City. Our findings can be used to invest in the most significant sources to reduce BTEX in HCMC. Our approach can be applied in similar urban areas in BTEX EI. This research also developed nine measures to reduce BTEX in HCMC for human health protection.