Owing to its abundance on earth and its multiple uses by humans, lead (Pb) is a major toxicant that has threatened human health for millennia and continues to do so. There is no safe level of exposure, necessitating a nuanced approach to its control in the food we consume, the water we drink, and the air we breathe. Turnover in soft tissues is within days. In contrast, lead accumulates in bone and turns over with a half-life of about 30 years, though it can be mobilized from bone under physiological and pathophysiological conditions of bone resorption. Children are particularly vulnerable to lead exposure and suffer irreversible neurological deficits affecting learning ability and behavior. In adults, chronic effects of exposure to lead include elevated blood pressure, development of cancers, and, as suggested more recently, neurodegeneration. Some pathways of systemic and cellular metabolism of Pb(II) are known. However, except for its action in δ-aminolevulinate dehydratase, its molecular toxicology remains largely speculative in terms of specific targets. One major molecular mechanism seems to be the replacement of zinc with lead in zinc proteins with functional consequences. Calcium binding proteins are also being discussed as possible targets. However, the affinities of lead for calcium sites in proteins are orders of magnitude lower than those for zinc sites. Therefore, it remains to be shown whether lead at the concentrations occurring in tissues can replace calcium in proteins in vivo. Despite humans having recognized the hazards of lead exposure for a very long time, uncertainties remain as to the threshold for adverse effects on our health and the low levels of exposure during our lives as a risk factor for chronic disease.