We conducted an analysis of leukemia mortality and protracted exposure to low-dose ionizing radiation. We used data from seven published epidemiologic studies of nuclear workers that reported individual monitoring information for radiation exposure. We found 83 leukemia deaths among white males from a combined total of more than 1.4 million person-years. We calculated an overall relative risk for leukemia of 1.5, after adjustment for age and calendar time, for workers with cumulative occupational doses of 10 mSv (1 rem) or greater, compared with those with cumulative doses of less than 10 mSv. An adjusted relative risk of 1.8 was observed when individuals with 10-50 mSv (1-5 rem) were compared with those who had cumulative occupational doses of less than 10 mSv. The adjusted relative risk for those with doses greater than 50 mSv relative to those with doses less than 10 mSv was 1.2, although the data were especially sparse in this dose range. These combined data indicate a small elevated risk of leukemia for doses of ionizing radiation under 50 mSv.