Background: As a result of Hurricane Katrina, > 100,000 homes were destroyed or damaged and a significant amount of sediment was deposited throughout the city of New Orleans, Louisiana. Researchers have identified the potential for increased lead hazards from environmental lead contamination of soils.Objectives: We assessed the distribution of residential soil and dust lead 2 years poststorm and compared soil lead before and after the storm.Methods: We conducted a cross-sectional study in New Orleans in which households were selected by stratified random sampling. A standard residential questionnaire was administered, and lead testing was performed for both the interior and exterior of homes. Logistic regression was used to identify significant predictors of interior and exterior lead levels in excess of allowable levels.Results: One hundred nine households were enrolled; 61% had at least one lead measurement above federal standards. Of homes with bare soil, 47% had elevated lead and 27% had levels exceeding 1,200 ppm. Housing age was associated with soil lead, and housing age and soil lead were associated with interior lead. Race, income, and ownership status were not significantly associated with either interior or exterior lead levels. The median soil lead level of 560 ppm was significantly higher than the median level of samples collected before Hurricane Katrina.Conclusions: The high prevalence (61%) of lead above recommended levels in soil and dust samples in and around residences raises concern about potential health risks to the New Orleans population, most notably children. Steps should be taken to mitigate the risk of exposure to lead-contaminated soil and dust. Further research is needed to quantify the possible contribution of reconstruction activities to environmental lead levels.