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Nestled in Madagascar's central highlands at an elevation of approximately 1,500 meters (4,900 feet), Antsirabe occupies a distinctive position as the third-largest city in the country, situated roughly 170 kilometers south of the capital Antananarivo. The city's geography is characterized by its location within the Vakinankaratra region, surrounded by rolling hills and volcanic landscapes that include the nearby Mount Ibity and Mount Andringitra to the south. This elevated terrain places Antsirabe in a valley-like basin, which can trap air pollutants under certain meteorological conditions, particularly during the cooler, drier months when temperature inversions are common. The city's urban character blends colonial-era architecture with bustling markets and thermal springs, drawing both residents and tourists to its mineral-rich waters. While not directly adjacent to major industrial belts, Antsirabe's economy relies on light manufacturing, agriculture, and tourism, with surrounding areas dedicated to rice paddies, vegetable farming, and dairy production. The urban–rural gradient is pronounced, as the city center transitions quickly into agricultural zones, contributing to particulate matter from biomass burning and soil dust. Proximity to Lake Tritriva, a volcanic crater lake about 15 kilometers away, offers some moderating effects on local microclimates but does not significantly mitigate pollution accumulation. The city's position away from coastal influences means it lacks the cleansing sea breezes found in Madagascar's port cities, allowing pollutants from vehicular emissions, residential heating with wood and charcoal, and occasional agricultural burning to persist, especially in the densely populated urban core.

Antsirabe's air quality follows a distinct seasonal pattern influenced by its highland tropical climate, with pollution levels fluctuating based on meteorological factors and human activities. During the austral summer (December to February), the rainy season brings frequent showers that help wash particulate matter from the air, resulting in generally better air quality; however, increased humidity can occasionally trap pollutants near the ground, particularly in the early mornings. This period is favourable for outdoor activities, with January and February offering clearer skies. As autumn (March to May) approaches, rainfall decreases, and temperatures begin to drop, leading to a gradual buildup of pollutants from biomass burning for heating and agricultural residue disposal. The winter months (June to August) mark the peak pollution period, as cold, dry conditions foster temperature inversions that trap emissions from vehicles, wood stoves, and dust in the valley basin, with July often being the worst month. Sensitive groups, such as children, the elderly, and those with respiratory conditions, should limit outdoor exertion during this time, especially in the mornings when inversions are strongest. Spring (September to November) sees improving conditions as temperatures rise and winds increase, dispersing pollutants, though occasional haze from pre-rainy season agricultural fires may occur. Throughout the year, fog can exacerbate pollution visibility issues, particularly in winter, but monsoon-like winds are absent due to the inland location. For health guidance, it is advisable to avoid strenuous activities during peak pollution months and monitor local weather reports for inversion warnings.