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Ingested soil and surface dust may be important contributors to elevated blood lead (Pb) levels in children exposed to Pb contaminated environments. Mitigation strategies have typically focused on excavation and removal of the contaminated soil. However, this is not always feasible for addressing widely disseminated contamination in populated areas often encountered in urban environments. The rationale for amending soils with phosphate is that phosphate will promote formation of highly insoluble Pb species (e.g., pyromorphite minerals) in soil, which will remain insoluble after ingestion and, therefore, inaccessible to absorption mechanisms in the gastrointestinal tract (GIT). Amending soil with phosphate might potentially be used in combination with other methods that reduce contact with or migration of contaminated soils, such as covering the soil with a green cap such as sod, clean soil with mulch, raised garden beds, or gravel. These remediation strategies may be less expensive and far less disruptive than excavation and removal of soil. This review evaluates evidence for efficacy of phosphate amendments for decreasing soil Pb bioavailability. Evidence is reviewed for (1) physical and chemical interactions of Pb and phosphate that would be expected to influence bioavailability, (2) effects of phosphate amendments on soil Pb bioaccessibility (i.e., predicted solubility of Pb in the GIT), and (3) results of bioavailability bioassays of amended soils conducted in humans and animal models. Practical implementation issues, such as criteria and methods for evaluating efficacy, and potential effects of phosphate on mobility and bioavailability of co-contaminants in soil are also discussed.