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Congenital heart defects are the most prevalent type of birth defects. The association of air pollution with congenital heart defects is not well understood. We investigated a cohort of 8969 singleton live births in Lanzhou, China during 2010–2012. Using inverse distance weighting, maternal exposures to particulate matter with diameters ≤10 μm (PM₁₀), nitrogen dioxide (NO₂), and sulfur dioxide (SO₂) were estimated as a combination of monitoring station levels for time spent at home and in a work location. We used logistic regression to estimate the associations, adjusting for maternal age, education, income, BMI, disease, folic acid intake and therapeutic drug use, and smoking; season of conception, fuel used for cooking and temperature. We found significant positive associations of Patent Ductus Arteriosus (PDA) with PM₁₀ during the 1st trimester, 2nd trimester and the entire pregnancy (OR _{1st trimester} = 3.96, 95% confidence interval (CI): 1.36, 11.53; OR _{2nd trimester} = 3.59, 95% CI: 1.57, 8.22; OR _{entire pregnancy} = 2.09, 95% CI: 1.21, 3.62, per interquartile range (IQR) increment for PM₁₀ (IQR = 71.2, 61.6, and 27.4 μg m⁻³, respectively)), and associations with NO₂ during 2nd trimester and the entire pregnancy (OR _{2nd trimester} = 1.92, 95% CI: 1.11, 3.34; OR _{entire pregnancy} = 2.32, 95% Cl: 1.14, 4.71, per IQR increment for NO₂ (IQR = 13.4 and 10.9 μg m⁻³, respectively)). The associations for congenital malformations of the great arteries and pooled cases showed consistent patterns. We also found positive associations for congenital malformations of cardiac septa with PM₁₀ exposures in the 2nd trimester and the entire pregnancy, and SO₂ exposures in the entire pregnancy. Results indicate a health burden from maternal exposures to air pollution, with increased risk of congenital heart defects.