The area burned by wildland fire has greatly increased in the U.S. in recent decades. Short-term exposure to smoke pollutants emitted by wildland fires, particularly PM 2.5 , is associated with numerous adverse health effects. However, the impacts of long-term exposure to wildland fire smoke PM 2.5 on health and specifically mortality remain unclear. Utilizing wildland fire smoke PM 2.5 and mortality data in the contiguous U.S. during 2007-2020, we found positive associations between long-term smoke PM 2.5 exposure and increased non-accidental, cardiovascular, ischemic heart disease, digestive, endocrine, diabetes, mental, and chronic kidney disease mortality rates. Each year, in addition to the well-recognized mortality burden from non-smoke PM 2.5 , smoke PM 2.5 contributed to an estimated over 10 thousand non-accidental deaths in the U.S. This study demonstrates the detrimental effects of wildland fire smoke PM 2.5 on a wide range of health outcomes, and calls for more effective public health actions and communications that span the health risks of both short- and long-term exposure.