Objectives: The aim of the study was to make an international comparison of blood levels of cadmium (B-Cd), lead (BPb) and mercury (B-Hg) of women in seven European, and three non-European cities, and to identify determinants. Materials and Methods: About 50 women (age: 46–62) from each city were recruited (totally 480) in 2006–2009. Interview and questionnaire data were obtained. Blood samples were analysed in one laboratory to avoid interlaboratory variation. Results: Between the European cities, the B-Pb and B-Cd results vary little (range of geometric means: 13.5–27.0 μg/l and 0.25–0.65 μg/l, respectively); the variation of B-Hg was larger (0.40–1.38 μg/l). Between the non-European cities the results for B-Pb, B-Cd and B-Hg were 19.2–68.0, 0.39–0.99 and 1.01–2.73 μg/l, respectively. Smoking was a statistically signifi cant determinant for B-Cd, while fi sh and shellfi sh intakes contributed to B-Hg and B-Pb, amalgam fi llings also contributed to B-Hg. Conclusions: The present results confi rm the previous results from children; the exposure to lead and cadmium varies only little between different European cities suggesting that other factors than the living area are more important. The study also confi rms the previous fi ndings of higher cadmium and lead levels in some non-European cities. The geographical variation for mercury is signifi cant.