Lead (Pb) concentration, speciation and bioaccessibility were measured in 122 household dust samples collected in rural areas of eight provinces of China. The mean Pb concentration in the household dust was 208mgkg−1, of which samples from sites in Hunan (538mgkg−1) and Yunnan (280mgkg−1) provinces exhibited the highest Pb concentrations while those from Shaanxi (96mgkg−1) and Fujian (80mgkg−1) provinces had a relatively low Pb content. The major fraction of Pb in the household dust samples was found to be strongly bound to Fe–Mn oxide phases (37%) while Pb present in minor fractions individually making up between 14 and 18% was characterized in falling orders as residual, carbonate, organic/sulphide, and exchangeable fractions by the sequential extraction method applied. Bioaccessible Pb making up an average proportion of 53% in the household dusts was significantly correlated to the Fe–Mn oxide phases of Pb. According to the Hazard Quotient (HQ), the ingestion of dust particles pose the highest risk to children in Chinese rural areas, followed by dermal contact and inhalation. Hazard Index (HI) values for most samples were lower than 1, indicating that the domestic Pb exposure in rural areas of China were relatively safe for children when they exposure to the household dust. However, dust Pb in 4.1% of the studied families having HI values higher than 1 may pose adverse health effect to the children.