To elucidate the effect of low level lead (Pb) exposure on somatic and automatic peripheral nerve functions in ceramic painters, 58 males and 70 females, aged 29–75 years (mean 53.3 years), with lead concentrations in blood (Pb-B) ranging from 2.1 to 69.5 μg/dl (geometric mean 13.3 μg/dl), were examined for median nerve maximal conduction velocity as a measure of motor nerve function, the coefficient of variation of R-R interval on electrocardiography as a measure of parasympathetic function, and postural changes in finger blood flow volume (ΔFBF), and changes in finger blood flow drop velocity (FDV) from the supine to standing position as a measure of sympathetic function. No significant association was found between Pb-B levels and the results of the neurophysiological tests, however, except for that between Pb-B and ΔFBF. ΔFBF was decreased linearly with increasing Pb-B levels. However, this association could not be concluded to be a reflection of sympathetic nerve dysfunction due to Pb exposure in the subjects, since ΔFBF was not a specific parameter of sympathetic nerve function. The possibility that the decrease in ΔFBF is a reflection of the atherosclerotic effect of chronic low level Pb exposure should be further investigated. © 1996 Wiley-Liss, Inc.