Air pollution can lead to the elevated incidence of various respiratory diseases, seriously endangering the health of urban residents. To better comprehend the association between urban air pollution and respiratory disease incidence, this study focused on Xinxiang City, a typical industrial city in the North China Plain, as the research object. By analyzing monthly air pollution index concentrations from 2018 to 2021 and confirmed cases of respiratory diseases, and incorporating meteorological factors as reference points, we conducted a correlation analysis between disease data and pollutant concentrations. We then constructed a Poisson regression model to obtain maximum likelihood estimates, which were used to predict the quantitative relationship between the incidence of respiratory diseases and air pollution indicators. The results showed that an increase of 1 μg/m³ in the average mass concentration of PM2.5, PM10, NO2, and SO2 in ambient air was associated with an elevated incidence of respiratory diseases by 0.2–1.4%, 0.7–1.6%, 3.7–8.2%, and 0.5–2.3%, respectively; meanwhile, a monthly mean mass concentration of CO increased by 1 mg/m³ led to a rise in pulmonary tuberculosis incidence by 2.9%. Additionally, based on health risk data following exposure to air pollution in Xinxiang City, it was confirmed that the impact of respiratory diseases as measured by the air quality composite index was more applicable than the single pollution index. Furthermore, there was a significant association between air pollution and the incidence of respiratory diseases.