Air pollution is a leading cause of death worldwide, and it has a profound impact on the planet’s climate and ecosystems. A substantial portion of air pollution is attributable to Ocean Going Vessels (OGVs). In light of this, international regulations have been put in place to mitigate air pollutant emissions from OGVs. While studies have indicated that these regulations can create significant health, environmental, and economic benefits, there remains a research gap regarding their specific impact on enhancing air quality. The aim of this study is to investigate how the implemented regulations have affected air quality in the Southern North Sea. The study found that the international regulations on ship emissions have successfully led to a decline in SO2 emissions from OGVs in the Southern North Sea, which resulted in a reduction of ambient SO2 concentrations inland, leading to positive effects on public health and the environment. However, the proportion of shipping’s contribution to SO2 emissions is projected to increase in the future. Moreover, the study revealed that the use of Exhaust Gas Cleaning Systems (EGCS) presents significant concerns. They were more frequently found to be non-compliant, and, more alarmingly, they emit higher mean levels of SO2. It also emerged that international regulations in the southern North Sea have less of an impact on the reduction of NOx emissions from OGVs than expected, which is all the more important given that NOx emissions from OGVs are expected to account for 40% of the total domestic NOx emissions for the northern region of Belgium by 2030.