The detrimental effects of modern lead exposure on human health are widely recognized. Evidence from the Roman era indicates substantial lead exposure that potentially impacted human health more than 2,000 y ago. The most significant exposure for the rural, nonelite population may have been to background air pollution from silver mining and smelting that underpinned the Roman economy. Using detailed records of Roman-era lead pollution measured in Arctic ice cores and atmospheric modeling, we show that lead emissions from these activities elevated air concentrations throughout Europe. Based on modern epidemiological studies, this air pollution enhanced childhood blood lead levels (BLLs) by about 2.4 µg/dl leading to widespread cognitive decline including an estimated 2.5-to-3 point reduction in intelligence quotient.