Crop residue burning contributes to poor air quality and imposes a health burden on India. Despite government bans and other interventions, this practice remains widespread. Here we estimate the impact of changes in agricultural emissions on air quality across India and quantify the potential benefit of district-level actions using an adjoint modeling approach. From 2003 to 2019, we find that agricultural residue burning caused 44,000–98,000 particulate matter exposure-related premature deaths annually, of which Punjab, Haryana, and Uttar Pradesh contribute 67–90%. Due to a combination of relatively high downwind population density, agricultural output, and cultivation of residue-intensive crops, six districts in Punjab alone contribute to 40% of India-wide annual air quality impacts from residue burning. Burning two hours earlier in Punjab alone could avert premature deaths up to 9600 (95% CI: 8000–11,000) each year, valued at 3.2 (95% CI: 0.49–7.3) billion US dollars. Our findings support the use of targeted and potentially low-cost interventions to mitigate crop residue burning in India, pending further research regarding cost-effectiveness and feasibility.