Background: Broken Hill is home to Australia's oldest silver–zinc–lead mine. However, the precise source of childhood blood lead (PbB) exposures has been subject to considerable debate. Lead sources include natural soil Pb enrichment, legacy deposition, contemporary mining emissions, and Pb-based paint. Objective: To test whether contemporary mining emissions independently affect childhood PbB in Broken Hill. Methods: Children's (<5 years old) PbB measures from 2011 to 2015 (n = 4852), obtained from Broken Hill Child & Family Health Centre, were analyzed using generalised linear regression models, including covariates of household soil Pb, city dust Pb concentrations (PbD), demographic factors and Pb ore production. Two natural experiments involving wind direction and the 2009 dust storm were examined to test whether the PbB-distance gradient from the mining operations was influenced by contemporary emissions. The influence of contemporary emissions was further interrogated by examining the effect of ore production on PbB and PbD. Results: Children living downwind and proximate to the mine had substantially higher PbB outcomes than children similarly distant but upwind. Dust Pb deposition increased significantly with proximity to mining operations as well to Pb production (1991–2013). Average annual PbB correlated with Pb ore production (p < 0.01) with all subsets of children PbB levels responding with near unit elasticity to Pb ore production (p < 0.01). Pre- and post-analysis of the dust storm showed the PbB-distance gradient remained statistically unaltered further confirming contemporary emissions as a source of exposure. Conclusions: Contemporary mining emissions influence children's PbB measures independent of other sources and need to be remediated to facilitate reductions in harmful exposure.