Background: With the worldwide increase of industrial pollution and man made or natural combustion activities, people are all exposed either voluntarily or involuntarily to certain environmental pollutants such as heavy metals and organic hydrocarbons. Objective: Investigating the associations between socio-demographic factors, and increased blood lead levels (BLLs) among primary school children in Damietta governorate. Patients and Methods: This was a cross sectional study. It was conducted from January 2015 till January 2016. The study was conducted on Damietta primary schools' students. The largest (in number of children in primary stage) school was selected as the primary target of the study (students number in all classes were 750 children; 741 cases were included in the statistical analysis). After ethical and administrative approval, all primary school children in the selected school were screened for blood lead levels and correlated with other sociodemographic factors. Socio-demographic information obtained from the questionnaire included sex, age, parental educations and occupations (unemployed, general labor, skilled labor, professional worker), neighborhood condition such as whether living in a crowed neighborhood, person directly raising the child, having sibling(s) or not, parental smoking at home and the mother's age when the child was born. Blood specimens were collected, and frozen and collected to the Research Center at Al-Mansoura University hospital for lead analysis. Results: Serum lead levels ranged from 5 to 36 µg/dl. The mean value (ISD) was 9.67±6.11. Cases with serum lead level more than or equal to 10 µg/dl were 98 out of 741 (13.2%) and assigned as a positive group. 390 cases (52.6%) were males. Males significantly increased in in positive group (69.4% vs 50.1% respectively). Also, there was a significant decrease in age of positive children (8.52±1.62 vs 9.79±1.69 years respectively). Child anthropometric measurements revealed significant decrease of weight, height and head circumference (HC) in positive when compared to negative cases. There was a significant increase of low social level in positive group when compared to negative group. Furthermore, there was a slight significant increase of percentage of rural residence in positive when compared to negative cases. Male gender, rural residence, parent smoking, outdoor play, eating canned foods, waste piles around house and base floor living are risk factors for increased level of lead above 10µg/dl. Conclusion: Results of the present study shed a light on the situation of serum lead levels in primary school children and associated factors in Damietta Governorate. However, it was just a step on a long road for development an effective strategy for decreasing exposure and harmful effects of lead on children.