This study investigated whether residential demolitions in Philadelphia are temporally and spatially associated with children’s blood lead levels (BLLs). We linked clinical test records from the Children’s Hospital of Philadelphia of patients with both brain MRI and BLL data to demolition records from the Department of Licenses and Inspections. For each child, we identified demolitions occurring within 5 km and 30 days of the test date, calculated maximum BLL, and measured local demolition activity. We then summarized BLLs across exposure quartiles, tested for monotone trends, and mapped tract-level correlations. At the city level, higher demolition counts were modestly but consistently associated with lower BLLs, a pattern confirmed by within-tract fixed-effects models that control for neighborhood differences. These findings highlight the complexity of the relationship between demolition activity and lead exposure, underscoring the need for further study to clarify causal pathways and temporal-spatial associations.