AbstractThis study examines the impact of living near tidal creeks or industries on blood lead levels among children below three years of age in Mumbai, India. Data were obtained from the National Family Health Survey‐2 (NFHS‐2) conducted in 1998, which covered a representative sample of the population. Of the 412 children tested for blood lead, 50% had elevated levels (≥10µg/dl). Several areas in Mumbai have higher rates of elevated blood lead levels than we would expect in general. After adjustment for the child's age, standard of living, anaemia, birth order, household type and utensils, children living in industrial areas were 1.7 (95% confidence interval: 1.3–2.8) times as likely to have lead levels ≥10µg/dl compared with children living in non‐industrial areas. Similarly, the odds ratio for children living in areas with a tidal creek was 1.3 (95% confidence interval: 1.1–2.2) compared with children from non‐tidal creek areas. These findings are of public health concern, as most children in Mumbai are likely to suffer some degree of intellectual impairment as a result of environmental lead exposure. The evidence shows the need for appropriate interventions in reducing the burden of lead poisoning due to environment‐related factors, at least in the few areas of the city where it is particularly high. Copyright © 2006 John Wiley & Sons, Ltd.