Aim: In the absence of published statewide notification data, the aim of this study was to analyse trends in notifiable blood lead levels (hereafter referred to as lead poisoning) in NSW from 1998 to 2008, to help inform lead poisoning notification policy. Methods: NSW blood lead poisoning notification data for 1998–2008 were extracted from the Notifiable Diseases Database and analysed by age, gender and Area Health Service of residence. Results: There were 6000 lead poisoning notifications from 1998 to 2008, with an average annual notification rate of 11.8 per 100 000 population for 1998–2003. This rate declined to an average of 4.0 per 100 000 population in the period 2004–2008. Males accounted for 92% of notifications, and males aged 20–59 years had average notification rates between 20 and 27 per 100 000 population. Children aged 0–4 years had notification rates of 9.3 per 100 000 population in girls and 13.6 per 100 000 population in boys. Conclusion: Notification rates have fallen dramatically, however children aged 0–4 years and men are disproportionately represented in lead poisoning notifications.