Climate change-driven temperature increases worsen air quality in places where coal combustion powers electricity for air conditioning. Climate solutions that substitute clean and renewable energy in place of polluting coal and promote adaptation to warming through reflective cool roofs can reduce cooling energy demand in buildings, lower power sector carbon emissions, and improve air quality and health. We investigate the air quality and health co-benefits of climate solutions in Ahmedabad, India—a city with air pollution levels above national health-based standards--through an interdisciplinary modeling approach. Using a 2018 baseline, we quantify changes in fine particulate matter (PM2.5) pollution and all-cause mortality in 2030 from increasing renewable energy use (mitigation) and expanding Ahmedabad’s cool roofs heat resilience program to cover 20% of available building roof area (adaptation). We apply local demographic and health data and compare a 2030 mitigation and adaptation (M&A) scenario to a 2030 business-as-usual (BAU) scenario (without climate change response actions), each relative to 2018 pollution levels. We estimate that the 2030 BAU scenario results in an increase of PM2.5 pollution of 4.13 µg/m3 compared to a 0.11 µg/m3 decline under the 2030 M&A scenario. Reduced PM2.5 pollution under 2030 M&A results in 1,216-1,414 fewer premature all-cause deaths annually compared to 2030 BAU. Achievement of Indian Clean Air Programme, national standards, or World Health Organization annual PM2.5 targets in 2030 results in up to 6,510, 9,047, or 17,369 fewer annual deaths, respectively, relative to 2030 BAU. This comprehensive modeling method is adaptable to estimate local air quality and health co-benefits in other settings by integrating climate, energy, cooling, land cover, air pollution, and health data. Our findings demonstrate that city-level climate change response policies can achieve substantial air quality and health co-benefits. Such work can inform public discourse on the near-term health benefits of mitigation and adaptation.