With a warmer and drier climate, there has been an increase in wildfire events in the Northwest US, posing a potential health risk to downwind communities. The Lewis–Clark Valley (LCV), a small metropolitan area on the Washington/Idaho border in the United States Intermountain West region, was studied over the time period of 2017–2018. The main objective was to determine the community’s exposure to particulate matter (PM2.5) and volatile organic compounds (VOCs) during wildfire smoke events and to estimate the associated health risk. VOCs were analyzed previously in the LCV using sorbent tube sampling and thermal-desorption gas-chromatography mass-spectrometry (TD-GC-MS) during several local smoke events in the 2017–2018 fire seasons. PM2.5 measurements were obtained from nearby agency monitors. PM2.5 reached up to 200 µg/m3 in 2017 and over 100 µg/m3 in 2018 in the LCV, and has been observed to be increasing at a rate of 0.10 µg m−3/yr over the past two decades. Benzene, a carcinogen and air toxic, was measured with concentrations up to 11 µg/m3, over ten times the normal level in some instances, in the LCV. The health risk in the LCV from benzene was calculated at seven extra cancers per million for lifetime exposure and thirteen extra cancers per million considering all air toxics measured. The other cities monitored showed similar lifetime cancer risk, due to benzene of about 6–7 extra cancers per million. This work is important, as it measures ground-level exposures of VOCs and demonstrates decreases in PM2.5 air quality over time in the region.