In India, particularly in state of Bihar, there are numerous small-scale and medium industries, which use lead-based raw materials that may pose health risks to workers. There are no workplace regulations for lead exposure. Moreover, there are no studies carried out on the blood lead levels (BLLs) of workers or on the contribution of common workplace practices to lead poisoning. A cross-sectional study on the BLLs of 45 automobile garage workers and 40 non-garage workers was carried out in the vicinity of Nalanda Medical College and Hospital, Patna, India. In addition to BLL analysis, data on some risk factors such as smoking, and chewing tobacco (gutka and pan parag) were gathered through structured questionnaires and interviews and data analysis was performed using SPSS (Version 16). The t-test was used to compare mean BLLs of study groups. The analysis of variance (ANOVA), Kruskal-Wallis, Pearson chi-square and odds ratio tests were used to investigate the associations between specific job type, smoking and/or tobacco chewing, service years and occurrence of nonspecific symptoms with BLLs. The mean BLL of the automobile garage workers was found to be significantly greater than that of the controls. The BLLs of all the lead-exposed individuals were found to be over 10 µg/dL, and 53% of them had BLLs ranging 12-20 µg/dL, with the remaining 47% having over 20 µg/dL. The BLL of the workers increased with the duration of working in an automobile garage. Individuals involved in manual car painting comprise a larger percentage (58%) of those with the highest BLLs (=20 µg/dL). Lead accumulation in individuals who chew tobacco in the work place was found to be faster than in those who are not used to chewing tobacco. The findings of the study have clearly demonstrated that the BLLs of automobile garage workers in Patna, Bihar are considerably high with a range of 11.73-36.52 µg/dL and the workers are in danger of impending lead toxicity. The BLLs of the workers are influenced by their occupational practices, chewing tobacco at the workplace, and the time spent working in an automobile garage.