Southeast Asia has a very high population density and is on a fast track to economic development, with most of the growth in electricity demand currently projected to be met by coal. From a detailed analysis of coal-fired power plants presently planned or under construction in Southeast Asia, we project in a business-as-usual scenario that emissions from coal in the region will triple to 2.6 Tg a–1 SO2 and 2.6 Tg a–1 NOx by 2030, with the largest increases occurring in Indonesia and Vietnam. Simulations with the GEOS-Chem chemical transport model show large resulting increases in surface air pollution, up to 11 μg m–3 for annual mean fine particulate matter (PM2.5) in northern Vietnam and up to 15 ppb for seasonal maximum 1 h ozone in Indonesia. We estimate 19 880 (11 400–28 400) excess deaths per year from Southeast Asian coal emissions at present, increasing to 69 660 (40 080–126 710) by 2030. 9000 of these excess deaths in 2030 are in China. As Chinese emissions from coal decline in coming decades, transboundary pollution influence from rising coal emissions in Southeast Asia may become an increasing issue.