Globally, air pollution is a significant cause of death, illness and social discomfort. The problem is particularly severe in Nigeria, the country with the highest number of premature deaths due to ambient particulate matter pollution in Sub Saharan Africa. It is especially worrying in Lagos, the country's commercial capital and one of the world's fastest growing megacities. Despite growing concerns about its deadly impacts, there is currently no reliable monetary estimate of the effects of ambient air pollution, nor a comprehensive control plan in Lagos. Using available ground-level monitored data and the most recent valuation techniques, this paper estimates that in 2018 alone, ambient fine particulate matter (PM 2.5) caused about 11,200 premature deaths, and generated a health cost of US$2.1 billion in Lagos. This is equivalent to about 2.1 percent of Lagos' GDP in the same year. These results call for an urgent plan of action to improve air quality in the city, with primary focus on the main pollution sources: road transport, industrial emissions, and power generation.