Indigenous peoples have elevated risk of lead (Pb) exposure as hunted traditional food can be contaminated with lead-containing ammunition. Recent scientific consensus states that there is no threshold level for Pb exposure. The objective of this study was to estimate dietary exposure to Pb among First Nations living on-reserve in the province of Ontario, Canada. A total diet study was constructed based on a 24-h recall and Pb concentrations for traditional foods from the First Nations Food, Nutrition, and Environment Study (FNFNES) and Pb concentrations in market foods from Health Canada. A probabilistic assessment of annual and seasonal traditional food consumption was conducted. Results indicate that traditional foods, particularly moose and deer meat. are the primary source of dietary Pb intake (73%), despite providing only 1.8% of the average caloric intake. The average dietary Pb exposure (0.21 mu g/kg/d) in the First Nations population in Ontario was 1.7 times higher than the dietary Pb exposure in the general Canadian population. Pb intake was associated with an estimated average increase in systolic blood pressure of 1.2 mmHg. These results indicate that consumption of foods hunted with Pb containing ammunition and shot puts the population at elevated risk of Pb toxicity. (C) 2017 Elsevier B.V. All rights reserved.