Significant emissions from transportation contribute to the formation of O3 and fine particulate matter (PM2.5), causing poor air quality and health. In this study, four scenarios were developed to understand how future fleet electrification and turnover of both gasoline and diesel vehicles affect air quality and health in the Houston Metropolitan area. These scenarios considered increased vehicle activity and various configurations of emissions controls. Comparing to a base year of 2013, model predictions for 2040 indicated a ∼50% emissions increase in the Business As Usual (BAU) case, and ∼50%, ∼75%, and ∼95% reductions in the three distinct emissions control cases, the Moderate Electrification (ME), Aggressive Electrification (AE), and Complete Turnover (CT) cases, respectively. Each modeling scenario was conducted using a high-resolution (1 km) WRF-SMOKE-CMAQ-BenMAP air quality and health modeling framework, which helped capture urban features in higher detail. The emissions control cases resulted in 1–4 ppb maximum 8 h O3 increase along highways and reductions both in the regions enclosed by the highways and those downwind. Simulated PM2.5 concentrations decreased between 0.5 and 2 μg m−3. Health impact results suggest that increased O3 and PM2.5 concentrations from the BAU case will lead to 122 additional premature deaths with respect to 2013. However, reduced emissions for the control cases (ME, AE, CT) will prevent 114–246 premature deaths. Additionally, about 7,500 asthma exacerbation and 5,500 school loss days will be prevented in the ME case, benefiting younger individuals. The economic benefits generally followed the same trends as health impacts. The analysis framework developed in this study can be applied to other metropolitan areas. The effects of motor vehicle electrification on power plant emissions were estimated using the Argonne National Laboratory's Autonomie data, and indicated the electrification load to be negligible as opposed to projected electricity generation.