Prescribed burning is an effective land management tool that provides a range of benefits, including ecosystem restoration and wildfire risk reduction. However, prescribed fires, just like wildfires, introduce smoke that degrades air quality. Furthermore, while prescribed fires help manage wildfire risk, they do not eliminate the possibility of wildfires. It is therefore important to also evaluate fire and smoke impacts from wildfires that may occur after a prescribed burn. In this study, we developed a framework for understanding the air quality and health related trade-offs between wildfires and prescribed fires by simulating a set of counterfactual scenarios including wildfires, prescribed fires, and postprescribed burn wildfires. We applied this framework to the case of the Gatlinburg wildfire and found that emissions from prescribed burns and subsequent wildfire were slightly lower than those from the wildfire itself. This reduction resulted in lower daily average concentrations and exposures of PM