At the end of the dry season, from early March to early April each year, extensive agricultural biomass waste burnings occur throughout insular mainland Southeast Asia. During this biomass-burning period, smoke aerosols blanketed the whole region and were transported and dispersed by predominant westerly and southwesterly winds to southern China, Taiwan, and as far southern Japan and the Philippines. The extensive and intense burnings coincided with some wildfires in the forests due to high temperatures, making the region one of the global hot spots of biomass fires. In this study, we focus on the effect of pollutants emitted from biomass burnings in March 2019 at the height of the burning period on the exposed population and their health impact. The Weather Research Forecast-Chemistry (WRF-Chem) model was used to predict the PM2.5 concentration over the simulating domain, and health impacts were then assessed on the exposed population in the four countries of Southeast Asia, namely Thailand, Laos, Cambodia, and Vietnam. Using the health impact based on log-linear concentration-response function and Integrated Exposure Response (IER), the results show that at the peak period of the burnings from 13 to 20 March 2019, Thailand experienced the highest impact, with an estimated 2170 premature deaths. Laos, Vietnam, and Cambodia followed, with estimated mortalities of 277, 565, and 315 deaths, respectively. However, when considering the impact per head of population, Laos exhibited the highest impact, followed by Thailand, Cambodia, and Vietnam. The results highlight the significant health impact of agricultural waste burnings in Southeast Asia at the end of the dry season. Hence, policymakers should take these into account to design measures to reduce the negative impact of widespread burnings on the exposed population in the region.