Abstract Despite the fact that lead poisoning is one of the most common pediatric health problems in the United States today, little is known about the prevalence and correlates of this disease among nonurban preschool children living in the southern United States. The purpose of this study was to measure the prevalence of abnormal lead levels and to explore the relationships between lead levels and gender, weight, hemoglobin, and ethnicity. Using a chart review protocol, data were collected from 81 charts of children enrolled in a Head Start program in Florida. The prevalence rate of elevated lead levels was 18.5%, a rate higher than that found in most previous research. No relationship was found between lead levels and gender, weight, hemoglobin, and ethnicity. The results highlight the importance of local screening efforts. Controversies in screening are discussed in this article in some detail with the aim of assisting health care providers make decisions about whether universal screening for lead levels in children is appropriate and whether use of the Centers for Disease Control questionnaire has sufficient value. Further study is needed regarding prevalence rates in different geographic areas in the United States, and factors associated with elevated lead levels.