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Background: Lead exposure shares many risk factors with delinquent behavior, and bone lead levels are related to self-reports of delinquent acts. No data exist as to whether lead exposure is higher in arrested delinquents. The goal of this study is to evaluate the association between lead exposure, as reflected in bone lead levels, and adjudicated delinquency. Methods: This is a case-control study of 194 youths aged 12–18, arrested and adjudicated as delinquent by the Juvenile Court of Allegheny County, PA and 146 nondelinquent controls from high schools in the city of Pittsburgh. Bone lead was measured by K-line X-ray fluorescence (XRF) spectroscopy of tibia. Logistic regression was used to model the association between delinquent status and bone lead concentration. Covariates entered into the model were race, parent education and occupation, presence of two parental figures in the home, number of children in the home and neighborhood crime rate. Separate regression analyses were also conducted after stratification on race. Results: Cases had significantly higher mean concentrations of lead in their bones than controls (11.0±32.7 vs. 1.5±32.1 ppm). This was true for both Whites and African Americans. The unadjusted odds ratio for a lead level ≥25 vs. <25 ppm was 1.9 (95% CL: 1.1–3.2). After adjustment for covariates and interactions and removal of noninfluential covariates, adjudicated delinquents were four times more likely to have bone lead concentrations >25 ppm than controls (OR=4.0, 95% CL: 1.4–11.1). Conclusion: Elevated body lead burdens, measured by bone lead concentrations, are associated with elevated risk for adjudicated delinquency. [Copyright &y& Elsevier]