ABSTRAK Polusi udara khususnya Particulate Matter 2.5 (PM2.5), merupakan masalah kesehatan lingkungan yang terus meningkat di wilayah urban dan berdampak terhadap kesehatan pernapasan. Menurut WHO pada 2019 polusi udara luar ruangan diperkirakan menyebabkan 4,2 juta kematian prematur di seluruh dunia. Kelompok rentan seperti anak-anak, lansia, dan individu dengan penyakit komorbid memiliki risiko tinggi mengalami gangguan pernapasan akibat paparan PM2.5. Penelitian ini bertujuan mengkaji hubungan antara paparan PM2.5 dan risiko penyakit pernapasan pada kelompok rentan di wilayah urban. Metode penelitian menggunakan Systematic Literature Review (SLR) dengan kerangka PECO (Population, Exposure, Comparison, Outcome) dan Diagram PRISMA Flow. Pencarian artikel melalui basis data Google Scholar dan ScienceDirect dengan hasil awal 5.086 artikel, 732 dari Google Scholar dan 4.354 dari ScienceDirect. Setelah penyaringan berdasarkan rentang tahun publikasi 2021–2026, status open access, duplikasi, skrining, dan penilaian kelayakan, diperoleh 13 artikel yang memenuhi kriteria. Penilaian kualitas artikel menggunakan Joanna Briggs Institute (JBI) Critical Appraisal Tool. Hasil analisis menunjukkan sebagian besar artikel melaporkan hubungan positif antara paparan PM2.5 di wilayah urban dengan peningkatan risiko gangguan pernapasan pada kelompok rentan. Anak-anak menjadi kelompok paling rentan terhadap ISPA, asma, dan pneumonia. Pada lansia dan penderita komorbid, paparan jangka panjang mempercepat penurunan fungsi fisiologis dan memperburuk kondisi klinis. Pada masyarakat urban, risiko bersifat multifaktorial dipengaruhi faktor perilaku, sosial ekonomi, dan aktivitas luar ruangan. Disimpulkan bahwa paparan PM2.5 di wilayah urban berhubungan positif dengan peningkatan risiko gangguan kesehatan pernapasan pada kelompok rentan dengan kerentanan bervariasi sesuai karakteristik fisiologis dan faktor risiko penyerta. Kata kunci: PM2.5, Penyakit Pernapasan, Kelompok Rentan, Wilayah Urban ABSTRACT Air pollution, particularly Particulate Matter 2.5 (PM2.5), is a growing environmental health problem in urban areas that negatively affects respiratory health. According to the WHO (2024), outdoor air pollution was estimated to have caused 4.2 million premature deaths worldwide in 2019. Vulnerable groups such as children, the elderly, and individuals with comorbidities are at high risk of developing respiratory disorders due to PM2.5 exposure. This study aims to examine the relationship between PM2.5 exposure and the risk of respiratory disease among vulnerable populations in urban areas. The method used is a Systematic Literature Review (SLR) based on the PECO framework (Population, Exposure, Comparison, Outcome) and the PRISMA Flow Diagram. Articles were searched through the Google Scholar and ScienceDirect databases, yielding an initial total of 5,086 articles, 732 from Google Scholar and 4,354 from ScienceDirect. After filtering based on publication year (2021–2026), open-access status, duplication removal, screening, and eligibility assessment, 13 articles met the inclusion criteria. The quality of the selected articles was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Tool. The results show that most articles reported a positive association between PM2.5 exposure in urban areas and an increased risk of respiratory disorders among vulnerable groups. Children were found to be the most vulnerable group to acute respiratory infections, asthma, and pneumonia. In the elderly and those with comorbidities, long-term exposure accelerated physiological decline and worsened clinical conditions. Among the urban population, risk was multifactorial, influenced by behavioral, socioeconomic, and outdoor activity factors. It is concluded that PM2.5 exposure in urban areas is positively associated with increased respiratory health risks among vulnerable groups, with susceptibility varying according to physiological characteristics and accompanying risk factors. Keywords: PM2.5, Respiratory Diseases, Vulnerable Groups, Urban Areas