The effects of emissions from coal-fired power plants on children's exposure to polycyclic aromatic hydrocarbons (PAHs) are not well understood.This study aimed to evaluate the sources and the urinary levels of 1-hydroxypyrene, a biomarker of exposure to PAHs, among children living in proximity to a coal-fired power plant.Study areas consisted of two high exposure and two low exposure communities, at different distances and directions from a large coal-fired power plant in central Taiwan. Study subjects included 369 children aged 1–13 years and randomly selected from each community. Each child's urinary 1-hydroxypyrene concentration was measured by a high-performance liquid chromatography-fluorescence detector method. Samples of ambient air were analyzed for PAHs using a gas chromatography–mass spectrometry method. Information on important factors was collected by an interview using a structured questionnaire. Multiple regression analysis was used to assess factors significantly associated with urinary 1-hydroxypyrene levels.Levels of PAHs in ambient air in the high exposure communities were higher than those in the low exposure communities. Children living in high exposure communities had higher mean urinary 1-hydroxypyrene concentrations than those in low exposure communities (0.186 and 0.194 vs. 0.113 and 0.122μmol/mol-creatinine, respectively). The difference in urinary 1-hydroxypyrene levels between the high exposure communities and one low exposure community remained significant after adjusting for age, gender, environmental tobacco smoke, dietary exposure, and traffic.Children living in communities downwind of and in proximity to the coal-fired power plant had significantly increased urinary 1-hydroxypyrene levels.