High concentrations of PM 2.5 in China have an adverse impact on human health and present a major problem for air quality control. Here we evaluate premature deaths attributable to chronic and acute exposure to ambient PM 2.5 at different scales in China over 2013-2017 with an air quality model at 5 km resolution and integrated exposureresponse methods. We estimate that 1,210,000 (95% Confidence Interval: 720,000-1,750,000) premature deaths annually are attributable to chronic exposure to PM 2.5 pollution. Chongqing exhibits the largest chronic per capita mortality (1.4‰) among all provinces. A total of 116,000 (64,000-170,000) deaths annually are attributable to acute exposure during pollution episodes over the period, with Hubei province showing the highest acute per capita mortality (0.15 ‰ ). We also find that in urban areas premature deaths are 520,000 (320,000-760,000) due to chronic and 55,000 (3,000-81,000) due to acute exposure, respectively. At a provincial level, the annual mean PM 2.5 concentration varies by ±20% due to interannual variability in meteorology, and PM 2.5 -attributable chronic mortality varies by ±8%, and by >±5% and ±1% at a national level. Meteorological variability shows larger impacts on interannual variations in acute risks than that in chronic exposure at both provincial (>±20%) and national (±4%) levels. These findings emphasize that tighter controls of PM 2.5 and precursor emissions are urgently needed, particularly under unfavorable meteorological conditions in China.