Chronic lead poisoning (saturnism) most often leads to impaired cognitive function and developmental delays in children. Measuring blood lead levels is the gold standard for diagnosing this condition, which often presents with few symptoms. Healthcare professionals play a crucial role in identifying children at risk of lead poisoning. However, in France, there is a significant gap in the identification of at-risk children. In particular, the factors influencing physicians’ decisions to order blood lead level tests are poorly understood. A cross-sectional study was conducted to identify barriers to detection by physicians in two departments. A random sample was drawn from general practitioners, private and hospital-based pediatricians, as well as school physicians and maternal and child health (MCH) physicians in the Allier and Puy-de-Dôme departments. Data on knowledge, practices, and attitudes regarding childhood lead poisoning, as well as sociodemographic data, were collected by telephone using a standardized questionnaire (42 items). The determinants of ordering a blood lead level test were analyzed using logistic regression with weighting and post-stratification. 266 physicians (52% of those contacted) responded. 32% of physicians reported asking parents about their child’s potential exposure to lead, and 22% reported having ordered a blood lead level test since January 1, 2000. 89% of physicians considered themselves poorly informed about lead poisoning. In multivariate analysis, being a private practice pediatrician (OR = 6.2, 95% CI = 1.3–30.0) or a hospital-based pediatrician (OR = 5.7, 95% CI = 1.6–20.9), asking parents about potential lead exposure (OR = 7.2, 95% CI = 3.3–15.5), and having a good understanding of regulatory measures (OR = 4.5, 95% CI = 1.3–16.3) were associated with prescribing a blood lead level test. In contrast, the likelihood of prescribing decreased with age (OR = 0.93, 95% CI = 0.89–0.98) and with knowledge of full reimbursement by the National Health Insurance (OR = 0.15, 95% CI = 0.0–0.5). Among general practitioners, practicing in a group practice was associated with a higher likelihood of prescribing blood lead tests (OR = 2.73, 95% CI = 1.1–6.6). The number of reported prescribers may be overestimated compared to actual practice. It is likely that physicians prescribed a blood lead level test before the implementation of full reimbursement, which explains the observed negative association. However, the barriers and training needs are consistent with the results obtained in other studies. The implementation by the DDASS of communication and medical training campaigns incorporating data on the local context (map of at-risk areas) is likely to help improve the identification of at-risk children in Auvergne, particularly among general practitioners. (R.A.)