Lead poisoning is a public health problem with a long-term impact on children globally. Nigerian children, in particular, are exposed to elevated blood lead levels (BLLs) from artisanal mining, unofficial battery recycling, occupational take-home contamination, leaded paint, legacy leaded gasoline pollution, and many other sources of pollution, despite decades of progress worldwide. This review provides information on the epidemiology, causes, health consequences, and prevention of pediatric lead poisoning in Nigeria, including children under five years of age, who are most impacted by lead neurotoxic effects. We then synthesized the relevant studies narratively. Exposure context was a significant determinant of reported BLLs. Urban communities without point sources had geometric means of around 4-16 µg/dL, with a few above 10 µg/dL; artisanal-mining groups had means of 35-119 µg/dL, with a typical level of 45 µg/dL. The risks of uncontrolled exposure were highlighted by the 2010-2013 Zamfara mining disaster, which resulted in about 400 child deaths and a median BLL of 119 µg/dL in the most affected area. Children of workers are also at risk of contamination from Nigeria’s vast informal industry, which includes battery recycling, painting and metalworking. Neurodevelopmental damage, anemia, growth retardation, renal failure and, at high exposures, mortality are among the health effects. Systematic prevention is hampered by inadequate infrastructure, poverty, and lax regulation despite chelation therapy, environmental remediation, workplace safety measures, and community education.