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Chicago's lead problem has been shown to disproportionately affect populations of color and lower socioeconomic status (SES). The disproportionate effects on low-income areas and communities of color can be traced back to several key decisions in Chicago's history. A search of the National Library of Medicine's MEDLINE/PubMed as well as Google, and Google Scholar was performed to find all articles relating to lead poisoning in Chicago, lead utilization, Chicago's municipal and political history, and lead physiology between May 2020 and May 2023. Additionally, several studies and textbooks were reviewed regarding the latest advancements in lead poisoning. The study identified several key political moves over the course of Chicago's history that have resulted in disproportionate toxicity in minority populations and those of lower SES. Lead is more readily absorbed in the pediatric population. Additionally, prior regulations had published acceptable blood lead levels (BLLs) in children, but more recent evidence indicates a myriad of detrimental effects in BLLs below that cutoff. There is substantial evidence to suggest that there is no acceptable BLL. Lead toxicity is generally improving nationally but there still exists a considerable need for improvement. Programs should be expanded to ensure that individuals living in communities most at risk of lead exposure have the means to both, replace lead-contaminated infrastructure, and to be able to supply these communities with affordable housing. From a physician and clinician standpoint, knowing the increased risk of lead poisoning in these populations should prompt earlier testing., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Goodwin et al.)