Lead poisoning remains a major problem in India due to the lack of awareness of its ill effects among the clinical community. Blood lead, d-aminolevulinic acid dehydratase (d-ALAD) and zinc protoporphyrin (ZPP) concentrations are widely used as biomarkers for lead toxicity The present study was designed to determine the impact of chronic lead exposure on selected biological markers. A total of 250 subjects, of both sexes, ranging in age from 20 to 70 years, were recruited. On the basis of BLLs, the subjects were categorized into four groups: Group A (BLL: 0-10 lg/dl), Group B (BLL: 10-20 lg/dl). Group C (BLL: 20-30 lg/dl) and Group D (BLL: 30-40 lg/dl) having BLLs of 3.60 ± 2.71 lg/dl, 15.21 ± 2.65 lg/dl, 26.82 ± 2.53 lg/dl and 36.38 ± 2.83 lg/dl, respectively. Significant changes in biological markers due to elevated BLLs were noted. The relation of BLL and biological markers to demographic characteristics such as sex, habits, diet and substances abuse (smoking effect) were also studied in the present investigation. Males, urban population, non-vegetarians, and smokers had higher blood lead levels. d-ALAD activity was found to be significantly lower with increased BLL (P \ 0.001), while the ZPP level was significantly higher with increased BLL (P \ 0.001). Further, BLL showed a negative correlation with d-ALAD (r = -0.425, P \ 0.001, N = 250) and a positive correlations with ZPP (r = 0.669, P \ 0.001, N = 250). Chronic lead exposure affects the prooxidantantioxidant equilibrium leading to cellular oxidative stress.