Iraq is one of the countries that have suffered from decades of heavy conflict, industrial activity, and little environmental regulation. As a result, notable environmental degradation has occurred. Urban environments, in particular, suffer severely from air pollution, which may be affecting reproductive health outcomes .This study examined the environmental pollution rates and infertility rates in 5 large urban areas in Iraq from 2019- 2023 .A cross-sectional ecological study was conducted across five large Iraqi cities. Air pollution data were obtained from monitoring stations and included PM2.5, PM10, NO2, SO2, and O3 measurements. Infertility rates were obtained from hospital records and fertility clinics. Statistical analysis was conducted employing Pearson correlation coefficients and multiple regression models .Overall, we found strong positive relationships between air pollution and infertility rates in both men (r=0.73, p<0.001) and women (r=0.68, p<0.001) with respect to PM2.5 concentrations. NO2 levels were also associated with decreased sperm quality parameters (r=-0.61, p<0.01). In areas where PM2.5 concentrations were >50 μg/m3, the infertility rates were 34% higher than those in areas with lower PM2.5 concentrations. Higher air pollution levels in urban Iraqi cities show associations with reproductive health outcomes. Meaning, there is an urgent need to address environmental health and policy reform in Iraq.