Studies about the association between lead exposure and the elevation of blood pressure and risk of hypertension are varied, while available data on blood lead levels (BLL) in workers with lead-exposure are scarce. This research aimed to evaluate associations between BLL and blood pressure in an occupational population-based study in Jiangsu province, China. We enrolled 21,688 workers in this study. Information on socioeconomic and occupational background was obtained with face-to-face interviews. BLL, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured, and hypertension status was confirmed. We found that workers in mini-factories had the highest average BLL (20.3 μg/dL; 95% CI, 19.0-21.6 μg/dL) for overall participants. The employees in private factories had higher BLL (9.6 μg/dL; 95% CI, 9.5-9.8 μg/dL). However, BLL was much lower (4.0 μg/dL; 95%CI, 3.7-4.2 μg/dL) in state-owned factories. Participants working in the electrical machinery and equipment manufacturing industry had higher BLL (9.1 μg/dL; 95% CI, 9.0-9.3μg/dL). Compared to those workers with ≤ 4.6 μg/dL BLL, workers with > 17.5 μg/dL BLL presented 1.34 mmHg and 0.70 mmHg average difference in SBP and DBP, respectively. The adjusted OR for hypertension was 1.11 (95%CI, 1.08-1.15) compared to the workers with > 17.5 μg/dL BLL and to those with ≤ 4.6 μg/dL BLL. In summary, we found that BLL was positively associated with SBP and DBP and with the morbidity of hypertension in occupational populations with a high concentration of lead exposure. It is important to formulate new standards of blood lead levels to screen for elevated lead exposure. In addition, a series of new systems of risk assessment should be established to further reduce and prevent lead exposure.