While fossil fuels' climate impacts are well-established, risks to fenceline communities remain underexplored globally. We mapped 18,000+ operating facilities across 170 countries, revealing 463 million people living within 1km facing elevated health risks. Our high-resolution spatial analysis shows 32% of existing facilities are preferencialy sited in critical ecosystems, with a staggering 69% of 3,500 planned facilities also set to target these critical areas, threatening 106 million additional people around the world.