Converting all U.S. onroad vehicles to hydrogen fuel-cell vehicles (HFCVs) may improve air quality, health, and climate significantly, whether the hydrogen is produced by steam reforming of natural gas, wind electrolysis, or coal gasification. Most benefits would result from eliminating current vehicle exhaust. Wind and natural gas HFCVs offer the greatest potential health benefits and could save 3700 to 6400 U.S. lives annually. Wind HFCVs should benefit climate most. An all-HFCV fleet would hardly affect tropospheric water vapor concentrations. Conversion to coal HFCVs may improve health but would damage climate more than fossil/electric hybrids. The real cost of hydrogen from wind electrolysis may be below that of U.S. gasoline.Modeling a switch from gasoline to hydrogen fuel cell vehicles suggests that reduced emissions could save several thousand lives annually in the United States. Modeling a switch from gasoline to hydrogen fuel cell vehicles suggests that reduced emissions could save several thousand lives annually in the United States.