This study was designed to investigate the effect of increased blood and tibia lead on the change of bone mineral density in retired male lead workers. One hundred nine retired male lead workers who worked in 4 different lead industries and 51 nonoccupationally lead exposed male subjects were recruited from March 2004 to October 2004. Bone mineral density(BMD) was measured by broadband ultrasound attenuation(BUA) at left calcaneous bone area with broadband ultrasound attenuation method of QUS-2(Metra Biosystems Inc, USA). Tibia bone lead was measured for skeletal bone lead with K-xray fluorescence(K-XRF) and blood lead was analyzed with flameless atomic spectrophotometer. Hemoglobin, hematocrit, serum calcium and iron were also analyzed. In addition, information for smoking and drinking status and basic personal data such as age and lead exposure were also collected using questionnaire inquiry. Blood lead was correlated with tibia lead (r=0.711) and these two variables were negatively correlated with BUA in bivariate analysis. BUA and tibia lead showed significant main effects on the change of blood lead after adjusting covariates. The effect modification by the level of BMD (low: lower than the median of BUA and high: higher than the median of BUA) was observed between the association of tibia lead and blood lead after adjustment of covariates. The subjects who had higher BMD seemed to have lower blood lead by the increase of tibia lead than those of lower BMD. In the multiple regression analysis of blood lead and tibia lead on BUA after adjustment of covariates, only blood lead showed statistically significant effect on BUA. This study confirmed that BMD and blood lead were significantly associated. To verify the causal association of BMD on blood lead and vice versa, further longitudinal studies are needed.