Policy Relevant Background (PRB) ozone concentrations are defined by the United States (U.S.) Environmental Protection Agency (EPA) as those concentrations that would occur in the U.S. in the absence of anthropogenic emissions in continental North America (i.e., the U.S, Canada, and Mexico). Estimates of PRB ozone have had an important role historically in the EPA’s human health and welfare risk analyses used in establishing National Ambient Air Quality Standards (NAAQS). The margin of safety for the protection of public health in the ozone rulemaking process has been established from human health risks calculated based on PRB ozone estimates. Sensitivity analyses conducted by the EPA have illustrated that changing estimates of PRB ozone concentrations have a progressively greater impact on estimates of mortality risk as more stringent standards are considered. As defined by the EPA, PRB ozone is a model construct, but it is informed by measurements at relatively remote monitoring sites (RRMS). This review examines the current understanding of PRB ozone, based on both model predictions and measurements at RRMS, and provides recommendations for improving the definition and determination of PRB ozone.