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The increase of global commerce and tourism makes the shipping sector an important contributor of atmospheric particles and gaseous pollutants. These have impacts on both health and climate, especially in populated coastal areas. Maritime activities could be an important driver for economic and social development, however, they are also an environmental pressure. Several policies were implemented in the last decades, at local/regional or international levels, mainly focused on reducing the content of sulphur in marine fuels. The last international IMO-2020 regulation was enforced on 1 January 2020. This work reviews some recent studies on this topic delineating current knowledge of the impacts of maritime emissions on air quality and health and the future projections relative to the benefits of the implementation of the new IMO-2020 regulation. In addition, future perspectives for further mitigation strategies are discussed.