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The objective of this study was to determine whether exposure to elevated concentrations of nitrogen dioxide (NO2) and particulate matter with aerodynamic diameter &amp;lt;2.5 (PM2.5) had adverse effects on longitudinal measures of insulin sensitivity (SI), \u03b2-cell function, and obesity in children at high risk for developing diabetes. Overweight and obese Latino children (8\u201315 years; n = 314) were enrolled between 2001 and 2012 from Los Angeles, CA, and followed for an average of 3.4 years (SD 3.1 years). Linear mixed-effects models were fitted to assess relationships between AAP exposure and outcomes after adjusting for covariates including body fat percent. Higher NO2 and PM2.5 were associated with a faster decline in SI and a lower SI at age 18 years, independent of adiposity. NO2 exposure negatively affected \u03b2-cell function, evidenced by a faster decline in disposition index (DI) and a lower DI at age 18 years. 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