•Adds high spatially-resolved exposure data compared to previous studies.•Mutually adjusted estimates for air and noise pollution in susceptible population.•Primary traffic pollutants were not more strongly associated with prognosis.•Traffic noise only moderately correlated with air pollution.•Modest association between traffic noise and mortality independent of air pollution. There is relatively little evidence of health effects of long-term exposure to traffic-related pollution in susceptible populations. We investigated whether long-term exposure to traffic air and noise pollution was associated with all-cause mortality or hospital readmission for myocardial infarction (MI) among survivors of hospital admission for MI. Patients from the Myocardial Ischaemia National Audit Project database resident in Greater London (n=18,138) were followed for death or readmission for MI. High spatially-resolved annual average air pollution (11 metrics of primary traffic, regional or urban background) derived from a dispersion model (resolution 20m×20m) and road traffic noise for the years 2003–2010 were used to assign exposure at residence. Hazard ratios (HR, 95% confidence interval (CI)) were estimated using Cox proportional hazards models. Most air pollutants were positively associated with all-cause mortality alone and in combination with hospital readmission. The largest associations with mortality per interquartile range (IQR) increase of pollutant were observed for non-exhaust particulate matter (PM10) (HR=1.05 (95% CI 1.00, 1.10), IQR=1.1μg/m3); oxidant gases (HR=1.05 (95% CI 1.00, 1.09), IQR=3.2μg/m3); and the coarse fraction of PM (HR=1.05 (95% CI 1.00, 1.10), IQR=0.9μg/m3). Adjustment for traffic noise only slightly attenuated these associations. The association for a 5dB increase in road-traffic noise with mortality was HR=1.02 (95% CI 0.99, 1.06) independent of air pollution. These data support a relationship of primary traffic and regional/urban background air pollution with poor prognosis among MI survivors. Although imprecise, traffic noise appeared to have a modest association with prognosis independent of air pollution.