The River Sacco Basin (Rsb) is a site of National interest, characterized by several environmental pressures such as industrial facilities. This study investigates the association between long-term exposure to industrial-PM10 and -NOx and cause-specific mortality (non-accidental, cardiovascular, respiratory, and cancer) in the Rsb in the 2006-2018 period. We enrolled 301,681 residents near 14 major industrial plants (grouped into 5 30-km2 spatial domains). Residential exposure to annual PM10 and NOx was considered as categorical exposure (high (>80th percentile), medium (50th-80th), and low (<50th)). We applied adjusted domain specific Cox regression models (covariates: age, sex, and deprivation index) and performed a relative meta-analysis. We obtain a pooled 34% increase in respiratory mortality for high PM10 levels. Elevated risks were also observed for non-accidental and cancer mortality, highlighting the need for continuous monitoring and preventive interventions.