BACKGROUND AND AIM: Blood pressure (BP) in childhood is an important risk factor for cardiovascular disease in adulthood. {In utero} exposure to metals has been associated with higher BP in childhood. However, most studies have evaluated elements individually and measured BP at a single time point. The objective of the current study was to investigate the impact of a complex mixture of metals on child BP trajectories and elevated BP at age 11. METHODS: The current study included 176 mother-child pairs from the Rhea Study in Heraklion, Greece who had three BP measurements in childhood (at ages 4, 6, and 11). We focused on eight metals (antimony, arsenic, cadmium, cobalt, lead, magnesium, molybdenum, selenium), which were measured by inductively coupled plasma mass spectrometry in maternal urine samples collected during pregnancy (median gestational age at collection: 12 weeks). Covariate-adjusted Bayesian Varying Coefficient Kernel Machine Regression and Bayesian Kernel Machine Regression were used to simultaneously evaluate these eight metals in relation to the change in BP from age 4 to 11 and elevated BP at age 11, respectively. RESULTS:J-shaped associations were observed between molybdenum and both systolic and diastolic BP at age 4. Similar associations were identified for both molybdenum and lead in relation to elevated BP at age 11. Positive associations between molybdenum and BP at age 4 (for concentrations 40-80 μg/L) were stronger at high levels of lead. Lead was positively associated with BP measures at age 4, but only at high levels of molybdenum. CONCLUSIONS:Co-exposure to high levels of molybdenum and lead during the prenatal period may contribute to increased BP at age 4, which in turn may contribute to elevated BP in adolescence. KEYWORDS: Metals, mixtures, blood pressure, childhood, BKMR, BVCKMR