As part of the National Surveillance System for Childhood Lead Poisoning (SNSSI), the Lyon Poison Control Center (CAP) collects data on blood lead levels in children residing in the Rhône-Alpes and Auvergne regions. To guide future efforts in these two regions aimed at raising awareness among health and social services professionals regarding the identification of children with lead poisoning, it was deemed appropriate to conduct a review of 10 years of childhood lead poisoning surveillance, from 1994 to 2003, based on data available in the Lyon CAP database, and to contextualize this with the initiatives undertaken locally by the public health services of Rhône-Alpes and Auvergne during this period (screening campaigns, efforts to encourage case identification). In Rhône-Alpes, from 1994 to 2003, 2,587 initial blood lead level screenings were conducted, primarily in four departments—Rhône, Loire, Ain, and Isère—where screening efforts were concentrated in a few cities. Maternal and Child Health Services (PMI) were the primary prescribers, and the program targeted young children (ages 1–2) living in older housing. In Auvergne, 516 initial lead screening tests were conducted, 67% of which took place in 1998. School health services were the primary prescribers, and screening efforts were concentrated in a few cities in Puy-de-Dôme, Haute-Loire, and Allier, primarily involving children aged 5–6 and 3–4 living in older housing. In Rhône-Alpes, the percentages of initial blood lead levels at or above 100 μg/L were relatively high at the start of the study period: between 1994 and 1996, they averaged 67% in the Rhône, 24% in the Loire, 23% in the Ain, and 14% in Isère. These percentages declined steadily, reaching an average between 2001 and 2003 of 7% in the Rhône, 5% in the Loire, 7% in the Ain, and 4% in Isère. In Auvergne, the percentages of initial blood lead levels of 100 μg/L or higher averaged 13% in Puy-de-Dôme, 6% in Allier, and 4% in Haute-Loire, noting that the majority of blood lead level tests were conducted in 1998. Overall, analysis of the characteristics of poisoned children shows that the factors most predictive of high blood lead levels are: - knowledge of other poisoned children in the immediate environment (family or neighborhood); - pica behavior; - living in a home built before 1948, particularly one in poor condition; - age, with higher blood lead levels among 1- to 3-year-olds; - a high number of children under 6 in the household (3 or more); - parents of sub-Saharan African origin and, to a lesser extent, North African or Middle Eastern origin. In addition to systematic screening campaigns in communities (schools, daycare centers, etc.) or around an industrial site in the Rhône department, initiatives aimed at encouraging healthcare professionals (particularly those in maternal and child health centers) to identify at-risk children and order blood lead tests for them have been carried out in the Rhône, Loire, Ain, Isère, and Auvergne; however, these efforts are limited to specific geographic areas, and analysis shows that without regular awareness-raising, engagement declines rapidly. In conclusion, it appears essential that not only PMI physicians but also general practitioners and private pediatricians be repeatedly educated on the systematic screening for risk factors of lead exposure in young children, particularly those between 1 and 3 years of age, across the entire country—not just in the largest departments—and, within those departments, not just in a few targeted cities or areas.