Rough idling in a Lexus ES300 can be caused by several issues, including dirty fuel injectors, a clogged air filter, or a failing mass air flow sensor. Additionally, problems with the ignition system, such as worn spark plugs or ignition coils, can contribute to uneven idling. It's also advisable to check for vacuum leaks, as these can disrupt the air-fuel mixture. A diagnostic scan can help identify the specific cause of the rough idle.
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