Lead exposure in the environment is a major hazard affecting human health, particularly for children. The blood lead levels in the local children living around the largest coking area in China were measured, and the source of blood lead and the main pathways of lead exposure were investigated based on lead isotopic ratios ( 207 Pb/ 206 Pb and 208 Pb/ 206 Pb) in blood and in a variety of media, including food, airborne particulate matter, soil, dust and drinking water. The children's blood lead level was 5.25 (1.59 to 34.36 as range) μg dL −1 , lower than the threshold in the current criteria of China defined by the US Centers for Disease Control (10 μg dL −1 ). The isotopic ratios in the blood were 2.111 ± 0.018 for 208 Pb/ 206 Pb and 0.864 ± 0.005 for 207 Pb/ 206 Pb, similar to those of vegetables, wheat, drinking water, airborne particulate matter, but different from those of vehicle emission and soil/dust, suggesting that the formers were the main pathway of lead exposure among the children. The exposure pathway analysis based on the isotopic ratios and the human health risk assessment showed that dietary intake of food and drinking water contributed 93.67% of total exposed lead. The study further indicated that the coal used in the coking plant is the dominant pollution source of lead in children's blood.