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The Clean Air Plan has been active in China since 2013 to mitigate severe PM2.5 pollution. In this study, we applied the air quality model WRF-Chem to simulate PM2.5 in the Yangtze River Delta (YRD) region of China in 2017, with the aim of assessing the air quality improvement and its associated health burden in the final year of the Clean Air Plan. To better describe the fate of various PM2.5 compositions, we updated the chemical mechanisms in the model beforehand, including heterogeneous sulfate reactions, aqueous secondary organic aerosol (SOA) uptake, and volatility basis set (VBS) based SOA production. Both the observation and simulation results agreed that the stringent clear air action effectively reduced the PM2.5 pollution levels by ∼ 30 %. The primary PM2.5 (−6 ∼ − 16 % yr−1) showed a more significant decreasing trend than the secondary PM2.5 (−2 ∼ − 8 % yr−1), which was mainly caused by the directivity of the clear air actions and the worsening ozone pollution in the recent years. The inconsistent decreasing trends of PM2.5 components subsequently led to an increasing proportion of secondary PM2.5. Nitrate particles, higher in the central and western YRD region, have replaced sulfate and have become the largest component of secondary inorganic aerosols year-round, except in summer, when strong ammonium nitrate evaporation occurs. In addition, SOA remains an important component (21 ∼ 22 %) especially in summer, most of which is produced from the oxidation and ageing of semi/intermediate volatile organic compounds (S/IVOC). Furthermore, we quantified the associated health impacts and found that the Clean Air Plan has largely reduced premature mortality due to PM2.5 exposure in the YRD region from 399.1 thousand to 295.7 thousand. Our study highlights the benefits of the Clean Air Plan and suggests that subsequent PM2.5 improvement should be geared more towards controlling secondary pollutants.