Lead poisoning occurred in a female neonate following in utero exposure to lead-contaminated herbal medicines. The neonate’s 24-year-old mother had been taking several tablets (brown ‘HSY-15’ red, pink and green; dosage and tablet compositions not stated), prescribed by an Ayurvedic doctor in India for a gastrointestinal complaint, periodically for 9 years. The brown and red tablets were subsequently found to contain high concentrations of lead. At 30 weeks’ gestation the mother presented with abdominal pain and progressive confusion culminating in seizures. Investigations revealed that she had a blood lead concentration of 5.2 µmol/l and chelation therapy was initiated. After 36 h she had an antepartum haemorrhage and labour was induced; she gave birth to a baby girl. The neonate was flaccid and areflexic with Apgar scores of 4 and 6. She was intubated and ventilated; fluoroscopy confirmed bilateral diaphragmatic palsy. The cord blood lead concentration was 7.6 µmol/l and, within 24 h of her birth, chelation therapy was initiated. Her blood lead concentration initially rose to 11.8 µmol/l then fell rapidly, with a urinary lead concentration of 52 µmol/l on day 3. Over the next few months, intravenous chelation therapy was repeatedly stopped and replaced by oral succimer, but each time her blood lead concentration again increased, necessitating reintroduction. By 3 months the infant’s blood lead concentration had fallen to 1.8 µmol/l and her peripheral weakness had almost resolved, but bilateral wrist drop and poor head control persisted. A brainstem auditory response at 4 months’ corrected age showed right sensorineural deafness. At 5 months she was discharged home with a blood lead concentration of 0.95 µmol/l and still receiving succimer. A neurodevelopmental examination revealed a 2-month delay.