The Centers for Disease Control and Prevention (CDC) named childhood lead poisoning prevention as one of the “Ten Great Public Health Achievements—United States, 2001-2010.” The CDC lowered its “level of concern” for lead exposure from ≥10 µg/dL to 5 µg/dL and changed the designation of that benchmark from “level of concern” to “reference value,” since research has shown that there is no “safe” level of blood lead. We undertook a statewide spatial analysis to assess the extent to which neighborhood-level disparities in lead poisoning persist in Rhode Island. Approximately 15% of children had a blood lead level of 5 µg/dL or higher. A significant decline over the study period was observed: in 2006, 20.6% of the children tested had an elevated blood lead level; by 2016, only 6.2% did. While there has been tremendous progress in reducing lead poisoning, substantial neighborhood disparities persist.