Analysis in this chapter supports an overall trend of decline in the percentage of polluted days since 2012. Yet, stricter and more centralized policy enforcement measures do not have truly significant, across-the-board effects in reducing pollution in China, and the fall in PM2.5 concentration has not translated into significant and sustained health benefits. The chapter also examines the success and failure of the government in tracking the ongoing targets it set for achieving final policy goals, paying special attention to the following issue areas: reduction of toxic emissions, attacking water pollution, energy, and industrial restructuring, policy coordination, public participation, and the use of market mechanisms. The mixed outcome in addressing air pollution highlights the constraints and flaws of China’s environmental governance model. It also suggests that decades of reform and opening up have not fundamentally changed the impromptu, non-participatory, unaccountable, and mobilizational policy process, which often leads to undesirable and unintended policy outcomes.