Highway reclamation (i.e., the removal of highways or placing existing highways underground to create mixed-use urban areas) is being implemented around the United States, often touting co-benefits for population health. As part of the Bipartisan Infrastructure Law and the Inflation Reduction Act, the Reconnecting Communities and Neighborhoods grant program is a first-of-its-kind investment in launching even more highway reclamation projects. Depending on how the projects are implemented, these projects may create gentrification (i.e., the displacement of poor long-time residents by wealthier new people), thereby displacing the populations these projects are designed to protect. However, little work has systematically examined the extent to which highway reclamation projects provide the promised benefits for neighborhood environments (e.g., reduced air pollution), minimize gentrification, and improve health outcomes. This commentary proposes a framework by which the multidimensional impacts of highway reclamation can be evaluated, unlocking potential new structural pathways toward urban health equity.