Experimental animal studies suggest that lead compounds may increase the risk of gliomas. To study whether occupational exposure to lead increases the risk, we followed nervous system cancer incidence among 20,741 employees biologically monitored for their blood lead (B-Pb) concentrations. We also performed a nested case-referent study, comprising 26 male cases of nervous system cancer (16 of which had gliomas). Those cases a B-Pb ≥ 1.4 µmol/L had a twofold increase in the odds ratio of nervous system cancer as compared with those employees whose B-Pb had not exceeded 0.7 µmol/L. The excess was confined to gliomas (odds ratio 11, 95% confidence interval 1.0 to 630 for B-Pb ≥1.4 µmol/L; overallPvalue for trend, 0.037). We obtained lifetime information on exposure and potential confounders for 58% of the cases. The odds ratio of glioma was associated with indices of lifetime exposure to lead, and potential confounders seemed not to explain the effects. The results suggest that there may be an association between occupational lead exposure and the risk of gliomas. No firm conclusions can be drawn because of the small number of cases and loss of material.