The public health leadership and management of lead exposure in a lead mining and smelting community in Mount Isa is an ongoing issue. There exists deficiencies in public health and environmental legal frameworks that regulate lead exposure and management in Mount Isa, Queensland. Although some positive practical measures on lead containment have been implemented, evidence suggests they are currently inadequate. Greater investments in public health leadership at a local and state level are required to address the ongoing issue of lead in Mount Isa.