Uruguay is a developing country of South America with about 3 million people, half of whom live in its principal city, Montevideo. This city has several lead pollution sources as emitting industries, most of them surrounded by residential neighborhoods, some still using lead pipes in drinking water systems of old buildings, and has areas of heavy traffic with cars that are still fueled with leaded gasoline. The toxic effects of this heavy metal are well known. Children are a very sensitive population and their early symptoms of intoxication are not always taken into account. Blood lead is a good indicator of recent exposure to lead influenced by inhalation and ingestion. The systematic data assessment of lead pollution and people exposure in Uruguay was not well known when the Department of Toxicology and Environmental Hygiene of the Faculty of Chemistry began to analyze lead in biological samples, first from exposed workers and next from children and the general population, including sensitive animal species like dogs. Several described studies were carried out analyzing for blood lead to assess lead uptake and to obtain reference values for Uruguayan populations. Since 1986, that Department is the only laboratory where blood lead analyses are done, and the analytical method has been controlled by an interlaboratory quality control program of the Ministry of Labour of Spain and confirmed by experts from the Laboratory of Occupational and Environmental Medicine of Lund, Sweden. Financial and technical support was obtained from Sweden (SAREC) and also from the University of the Republic of Uruguay. Uruguayan lead workers have always been the principally studied population because their lead exposure assessment as well as their health protection education is not always done properly. Uruguay has adopted ACGIH reference values (150 micrograms/m3 in total lead dust, 50 micrograms/m3 respirable lead dust, 300 micrograms/L blood), and the high blood lead levels indicate significant adverse health risks effects and show a lack adequate controls for working conditions. A surveillance of children living in the surroundings of lead processing factories and in different neighborhoods was conducted because no data were available for blood lead in children before 1992. Also, general populations living in those areas or in areas of heavy traffic were assessed. Blood lead levels were always compared with those of control populations sampled at the same time answering a questionnaire. Workplace influence as well as atmospheric, soil, and water pollution were always considered to explain the obtained results. Some studies were carried out in dogs as a sensitive population, showing their higher exposure. The described studies included internal and external quality controls for the analytical methods and data processing. All blood lead analyses were done by atomic absorption spectrometry (AAS) after adding complexing agent and extraction. Samples taken together with Swedish researchers were analyzed in Lund (Department of Occupational and Environmental Medicine University Hospital), at 283.3 nm after electrothermal atomization (ETA). There was good correlation (r = 0.96) among 28 samples shared between Montevideo and Lund laboratories. The authors recommend more systematic clinical examination of workers, children, and the general population to determine the potential health risks for Uruguayan populations so as to improve their health conditions and to officially recognize lead pollution as an environmental problem.