Studies on the effects of lead on the somatic growth of children are limited and contradictory. The authors investigated the adverse effects of blood lead concentration on the somatic growth of primary-school-age children. In this study, there was a total of 522 children, aged 6-9 y, who resided in three areas of Greece (i.e., Loutraki, Lavrion, and Elefsina). The medical evaluation included medical history; physical examination; and measurements of height, head circumference, and chest circumference. The authors also evaluated dietary information, socioeconomic status, and height of parents. The authors conducted laboratory tests for hematological parameters and blood lead levels. The mean blood lead level was 12.3 microg/dl (standard deviation = 8.9 microg/dl), and levels ranged from 1.3 microg/dl to 51.2 microg/dl. There were negative monotonic relationships between growth parameters and blood lead levels, even after the authors allowed for confounding effects. An increase in blood lead level of 10 microg/dl was associated with a decrease of (a) 0.33 cm in head circumference (95% confidence interval = 0.12, 0.55; p = .002); (b) 0.86 cm in height (95% confidence interval = 0.14, 1.16; p = .020); and (c) 0.40 cm in chest circumference (95% confidence interval = -0.22, 1.02; p = .207). These findings led the authors to conclude that a decrease in growth in children may be associated with blood lead concentrations.