In 2015, the forest fires are quite severe in Riau Province. This causes the reduction of air quality, which in turn can cause breathing problems. This article aims to determine the relationship of the increase in air pollution index (API) and the cases of respiratory problems in Pekanbaru City in 2015. The study design was cross-sectional. Samples are all people with respiratory problems (Upper Respiratory Tract Infections/URI, asthma, and pneumonia) who visited Puskesmas or health post in Pekanbaru, amounted to 12,939 people. Data collected were daily data of API and Pekanbaru residents visit to Puskesmas and health posts with complaints of respiratory problems. Spearman rho correlation test was used to analyze the data with SPSS software. API from July to October 2015 range was quite wide from 34.7 up to 778.0. Average API in September and October 2015 were more than in the period of July and August 2015. The Spearman rho correlation analysis showed that the API value have significant correlation (p=0.000) with respiratory problems. Correlation between API with URI, asthma, and pneumonia is highest on the lag time 0, respectively 0.779; 0.237; and 0.436. It can be concluded that the increased API will increase URI on the same day.