Background: Lead is the toxic heavy element in the environment. Human exposure to lead and its compounds occurs mostly in lead-related occupations such as car repair, battery manufacturing and recycling, refining, smelting. Lead is a highly poisonous metal affecting almost every organ in the body. Lead inhibits necessary enzymes required for heme synthesis, and this results in increased levels of delta-aminolevulinic acid (δ-ALA) excretion through urine. Aim: To estimate the urinary δ-ALA acid levels in garage workers as an index of lead exposure. Materials and methods: This is a cross-sectional study in Mumbai from different suburban localities. The study was done on 72 garage workers of age group between 18 years and 50 years with their brief history related to lead exposure. Their urine samples were analyzed for δ-ALA by Ehrlich method. Results: According to our observation, it was found that out of 72 urine samples 19 samples (26.38%) have urinary δ-ALA levels below reference value (<5 mg/L), while 53 samples showed increased urinary δ-ALA levels (73.61%); out of these, 45 workers (84.90%) fall in the moderate-to-high exposure level category (5 or >5 to 20 mg/L), 8 workers (15.09%) fall in the dangerous—very high exposure level category (20 or >20 to 40 mg/L). Conclusion: The prevalence of lead exposure among our study population is 73.61%. Clinical significance: We conclude that there is high prevalence of lead exposure in garage workers in Mumbai, and necessary precautions need to be taken to avoid it.