Urban air pollution is a matter of increasing concern in many of the newly independent states (NIS). Traffic is burgeoning in cities, but vehicle registration, inspection, and maintenance lag behind what is needed to support efforts to improve air quality. Poor fuel quality worsens the emissions problems. Although certain emissions, such as greenhouse gases, are of global concern, the greatest costs of air pollution at the local level are to human health. This study examines the obstacles to improving air quality in the countries of Central Asia and the Caucasus and makes observations about the present air quality and monitoring systems and recommendations for improvement.