Commercial vehicle movements have a large effect on traffic-related air pollution in metropolitan areas. In the Greater Toronto and Hamilton Area (GTHA), commercial vehicles include large and medium diesel trucks as well as light-duty gasoline-fuelled trucks. In this study, the emissions of various air pollutants associated with diesel commercial vehicles were estimated and their impacts on urban air quality, population exposure, and public health were quantified. Using data on diesel trucks in the GTHA and a chemical transport model at a spatial resolution of 1 km, the contribution of commercial diesel movements to air quality was estimated. This contribution amounts to about 6-22% of the mean population exposure to nitrogen dioxide (NO) and black carbon (BC), depending on the municipality, but is systematically lower than 3% for fine particulate matter (PM) and ozone (O). Using a comparative risk assessment approach, we estimated that the emissions of all diesel commercial vehicles within the GTHA are responsible for an annual total of at least 9810 Years of Life Lost (YLL), corresponding to $3.2 billion of annual social costs. We also assessed the impact of decreasing freeway-sourced diesel emissions along Highway 401, one of the busiest highways in North America. This is comparable with a removal of 250 to 1000 diesel trucks per day along that corridor, which could be replaced by alternative technologies. The mean NO and BC exposures of the population living within 500 m of the highway would decrease by 9% and 11%, respectively, with reductions as high as 22%. Such a measure would save 1310 YLL annually, equivalent to $428 million in social benefits.