Based on real-time tracking data, PM2.5 mass concentration, and meteorological observations of the Tianjin Meteorological Bureau and the Ecological Environment Bureau, combined with the fine particle meteorological condition diffusion index constructed using the environmental model, the change and driving factors of the PM2.5 mass concentration in Tianjin from 2000 to 2020 were studied to analyze the impact of meteorology on the atmospheric environment. The study showed that change in PM2.5 mass concentration in Tianjin took place in three stages from 2000 to 2020; the first stage showed a continuous increase from 2000 to 2007. The rapid increase in emissions in this stage was the dominant factor, and its effect was four times that of the annual fluctuation in meteorological conditions. The second stage was from 2007 to 2013, in which the PM2.5 mass concentration fluctuated, with two peak years (2007 and 2013). The emissions were stable in this stage. The annual fluctuation of meteorological conditions had an important influence on the annual fluctuation in PM2.5 mass concentration. The third stage was from 2013 to 2020; the PM2.5 mass concentration decreased rapidly, and the decline in emissions was decisive, which reduced the PM2.5 mass concentration by 40% to 50%. The improvement in the meteorological diffusion conditions also provided a positive contribution, which reduced the PM2.5 mass concentration by approximately 10%. Based on the analysis of the data over the past 20 years, the annual variation in atmospheric diffusion conditions caused by the annual variation in meteorological conditions was periodic, with trough values from 2003 to 2004 and 2013 to 2015 and peaks from 2008 to 2010 and 2018 to 2020; the distance between peaks and valleys was approximately 11 years. It was estimated that the next atmospheric diffusion condition valley stage will occur circa 2025. The average intensity of the annual fluctuation in atmospheric diffusion conditions caused by the annual variation in meteorological conditions was 4%, which can explain 25%-50% of the annual variation in PM2.5 mass concentration over the past 20 years, with a difference between peaks and valleys of 16%. The periodic fluctuations in meteorological diffusion conditions have an important impact on the future PM2.5 target setting and corresponding measures design.