Wildfire smoke is a major environmental health hazard in Mediterranean regions such as Greece. Fine particulate matter (PMâ‚‚.â‚…) and toxic gases contribute to acute and chronic respiratory diseases, elevate cardiovascular morbidity and mortality, and produce long- term psychological impacts. This paper synthesizes epidemiological evidence, describes underlying pathophysiological mechanisms, and proposes integrated public health and policy strategies to mitigate wildfire-related health risks. In addition, it highlights research and policy gaps relevant to the Mediterranean context, emphasizing the need for economic and health preparedness.