A majority lead exposed children in the US will have no signs or symptoms of lead toxicity because most poisonings are subclinical (BLL < 45 μg/dL). These children will be asymptomatic at the time of exposure, with adverse effects only becoming evident as they grow older. Blood lead testing is the best way to identify lead exposed children and intervene to minimize risks for adverse outcomes. Clinically evident effects of acute toxicity typically occur around BLLs of 45 µg/dL and include anemia, abdominal pain, nephropathy, and encephalopathy. Children may present with nonspecific symptoms that progress with increasing blood lead levels. Symptoms may include headaches, abdominal pain, loss of appetite or constipation, signs of clumsiness, agitation, or decreased activity and drowsiness, vomiting, stupor, and convulsions. Subtle symptoms, such as anorexia or abdominal discomfort, may occur in some children starting around BLLs of 20μg/dL.