Wildland fires degrade air quality and adversely affect human health. A growing body of epidemiology literature reports increased rates of emergency departments, hospital admissions and premature deaths from wildfire smoke exposure. Objective: Our research aimed to characterize excess mortality and morbidity events, and the economic value of these impacts, from wildland fire smoke exposure in the U.S. over a multi-year period; to date no other burden assessment has done this. Methods: We first completed a systematic review of the epidemiologic literature and then performed photochemical air quality modeling for the years 2008 to 2012 in the continental U.S. Finally, we estimated the morbidity, mortality, and economic burden of wildland fires. Results: Our models suggest that areas including northern California, Oregon and Idaho in the West, and Florida, Louisiana and Georgia in the East were most affected by wildland fire events in the form of additional premature deaths and respiratory hospital admissions. We estimated the economic value of these cases due to short term exposures as being between $11 and $20B (2010$) per year, with a net present value of $63B (95% confidence intervals $6–$170); we estimate the value of long-term exposures as being between $76 and $130B (2010$) per year, with a net present value of $450B (95% confidence intervals $42–$1200). Conclusion: The public health burden of wildland fires—in terms of the number and economic value of deaths and illnesses—is considerable.