The purpose of this study was to analyze the air quality in Hangzhou and its surrounding areas during the 2023 Asian Games and assess the impact of safeguard measures on air quality. By comparing air quality monitoring data from Hangzhou and nearby cities between 23 September 2023, and 8 October 2023, with the same period in 2022, the analysis focused on the changes in air quality and the impact of PM2.5 and O3 on human health. The results show that during the 2023 Asian Games in Hangzhou, compared to the same period in 2022, the concentrations of pollutants showed the following changes: PM10 and NO2 concentrations decreased by 16.1% and 34.1%, respectively. PM2.5, CO, and O3 concentrations increased by 0.9%, 9.5%, and 14.4%, respectively. Spatially, compared with the same period in 2022, the PM2.5 concentration in Quzhou City decreased the most, reaching 23%, while the PM2.5 concentration in Huzhou City increased the most, reaching 27.1%. The largest decrease in PM10 concentration is in Wenzhou City, which is up to 28.2%, while the largest increase is in Zhoushan City, which is 9.2%. The concentration of NO2 generally decreases in all regions, with the biggest decrease in Zhoushan City, which reaches 36.2%. The concentration of CO only decreases in Shaoxing, and the highest increase is in Huzhou City. In terms of O3, the largest proportion increase is 23% in Ningbo. During the 2023 Asian Games in Hangzhou, the number of deaths from all-cause and cardiovascular diseases caused by short-term exposure to PM2.5 was 1780 and 795, respectively, which was 8.2% lower than the same period in 2022. During the Asian Games, the number of deaths from all-cause and cardiovascular diseases due to short-term exposure to O3 was 7332 and 3177, respectively, an increase of 2.8% compared with the same period in 2022.