Heavy-duty vehicles (HDVs) disproportionately contribute to the creation of air pollutants and emission of greenhouse gases—with marginalized populations unequally burdened by the impacts of each. Shifting to non-emitting technologies, such as electric HDVs (eHDVs), is underway; however, the associated air quality and health implications have not been resolved at equity-relevant scales. Here we use a neighbourhood-scale (~1 km) air quality model to evaluate air pollution, public health and equity implications of a 30% transition of predominantly diesel HDVs to eHDVs over the region surrounding North America’s largest freight hub, Chicago, IL. We find decreases in nitrogen dioxide (NO 2) and fine particulate matter (PM 2.5) concentrations but ozone (O 3) increases, particularly in urban settings. Over our simulation domain NO 2 and PM 2.5 reductions translate to ~590 (95% confidence interval (CI) 150–900) and ~70 (95% CI 20–110) avoided premature deaths per year, respectively, while O 3 increases add ~50 (95% CI 30–110) deaths per year. The largest pollutant and health benefits simulated are within communities with higher proportions of Black and Hispanic/Latino residents, highlighting the potential for eHDVs to reduce disproportionate and unjust air pollution and associated air-pollution attributable health burdens within historically marginalized populations.