Lead (Pb) has gained much attention since the 1970s because of its potential and cumulative toxicity. As one of the most hazardous elements in coals, Pb can be released into the environment during coal mining, processing, and utilization. This study presents a synthesis on the abundance, distribution, modes of occurrence, and environmental impacts of Pb in Chinese coals. Using the expected coal reserves as the weighting factor and based on the previously published Pb content in 4,304 coal samples (including results obtained in our laboratory) from main coalfields or coal mines in China, the weighted mean Pb content in Chinese coals is 13.0 mu g/g, which is higher than that of the American coals (11 mu g/g) and average world coals (7.8 mu g/g). With respect to regional distribution of Pb in Chinese coals, Pb content can be arbitrarily divided into three groups (< 20, 20-40, > 40 mu g/g). Following this classification, coals from Tibet have the highest average Pb content (128.94 mu g/g). The abundance of Pb in coals varies with coal-forming periods and coal ranks, with the late Triassic and higher rank coals having the highest Pb content, which could be ascribed to regional geochemical differences and later geological evolution as well as magma hydrothermal activities. The enrichment of Pb in coals is influenced by several geological factors, including coal-forming plants, source rocks, hydrothermal fluid, and depositional environment. Pb, dominantly associates with sulfide minerals, especially galena in coals. During coal combustion or pyrolysis, Pb is partly emitted into the atmosphere and partly partitioned to solid residues. Accumulation of Pb from coal utilization in human body could lead to a range of health problems and increase the risk of cancer.