Objective To predict the health impacts from air pollution from a big high speed highway in communities living within 1000 m of the road. Background: High speed travel, along with congestion, promotes and increases air pollution and its health risks, notably from particulates emissions from diesel vehicles. Vehicle emissions of all pollutants per vehicle-km travel increase at speeds exceeding 90 kph in Euro II petrol cars and diesel vehicles, exponentially for PM10, CO, and NOx, and arithemtically for CO2, the major greenhouse gas. ‘Predict and provide’ scenarios promote more roads and traffic. Methods We assessed future health risks from the the Trans Israel Highway and its 16 connecting roads, using exposure-effect data on thresholds for risk (Kunzli, N, Kaiser, R., Medina, S. et al. 2000. Public health impact of outdoor and traffic- related air pollution: a European assessment. Lancet 356 (9232): 795–801), observed time trends in effects on symptoms in urban school children, and exposure-effect relationships between respirable PM in schoolchildren exposed to traffic, notably diesel trucks. We took into account increases in emissions from high speed travel. Results Among approximately 202,000 residents in the corridor near the highway, the models based on the findings from the Tel Aviv area, the Netherlands study, and dose-response data suggest some1500 new cases at additional risk for asthma for each additional 10 ug/m3 of Respirable Suspended Particulates (PM10) a linear model of risk and a exposure levels of 60 ug/m3, the permissible exposure level predicts approximately 9,000 additional persons with asthma from permissible exposures. All these estimates do not take into account persons exposed to pollution from the 13–16 connecting roads. Increased travel speeds would increase these risks. Conclusions Strategies to reduce highway travel speeds-a measure targeted at road deaths-should reduce vehicular emissions and their adverse health effects and produce economic incentives for modal shifts. More trains and pollution free busses, rail shipment of heavy goods, stopping construction of new roads, specifying lower maximum speeds for vehicles-notably diesel trucks, restricting traffic in cities and shifts to other fuels are definitive strategies for arresting and reversing the adverse effects of ‘predict and provide’.