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While numerous studies have associated maternal exposure to PM 2.5 with adverse birth outcomes, findings remain inconsistent and difficult to generalize. We aimed to investigate the causal relationship and window of sensitivity between gestational exposure to PM 2.5 and birth outcomes. We leveraged high-resolution satellite data to quantify gestational PM 2.5 exposure at the individual level, along with a combined model to determine daily relative risks (RRs) of birth outcomes in COVID-19 prelockdown and lockdown groups. RRs between the two groups were further compared using a longitudinal pre-post non-experimental design to identify sensitivity windows of adverse birth outcomes. A total of 73,781 pregnant women from the COVID-19 prelockdown group and 6267 pregnant women from the lockdown group were included for analysis. The daily mean PM 2.5 concentrations in the lockdown group decreased by 21.7% compared to the prelockdown group. During the first trimester, every 10 μg/m3 increase in PM 2.5 significantly increased the risk of congenital abnormalities of major organs such as the cardiovascular system, gastrointestinal tract, nervous system, urinary system, and respiratory system. Moreover, gestational exposure to PM 2.5 during the first trimester was associated with higher risks of premature delivery and term low birth weight. While PM 2.5 exposure during the second trimester was positively correlated with macrosomia. Gestational exposure to PM 2.5 is associated with increased risks of various adverse birth outcomes with specific sensitive windows. We demonstrated that gestational exposure to PM 2.5 increased risks of various adverse birth outcomes with specific window of sensitivity through the natural experiment design. Our findings underscore the urgent need for policies and initiatives targeting PM 2.5 reduction, especially during critical periods of pregnancy. [Display omitted] • Gestational exposure to PM 2.5 increases the risks of adverse birth outcomes. • The critical windows of susceptibility to PM 2.5 differed between birth outcomes. • Our findings emphasize the urgent intervention reducing gestational PM 2.5 exposure. [ABSTRACT FROM AUTHOR]