In order to monitor cadmium contamination in lettuce quickly, non-invasively, and accurately, and to understand the growth status of lettuce under cadmium pollution, lettuce was used as the test material to detect and analyze the visible–near-infrared reflectance spectra and leaf cadmium content under different concentrations of cadmium stress. A model for estimating lettuce leaf cadmium content was established. For model establishment, firstly, the original spectra were preprocessed using smoothing (Savitzky–Golay, SG), SG combined with multiplicative scatter correction (MSC), SG combined with standard normal variable transformation (SNV), SG combined with mean normalization (MN), SG combined with the first derivative (FD), SG combined with the second derivative (SD), SG combined with the baseline offset (B), and SG combined with de-trending (D). Then, the principal component analysis (PCA) was applied to perform dimensionality reduction on the data. Finally, the reduced dataset was divided into training and testing sets in a 2:1 ratio, and separate models for estimating the lettuce leaf cadmium content were built using partial least squares regression (PLSR), the backpropagation neural network (BP-NN), and support vector regression (SVR) in combination. The results showed that the accumulated cadmium content in lettuce leaves increased with an increase in the soil cadmium concentration. In the visible light range, the spectral reflectance of lettuce leaves increased with an increase in the cadmium concentration. In the near-infrared range, the spectral reflectance of the lettuce leaves under 10 mg/kg and 20 mg/kg cadmium stress was lower than that of the control group. The PLSR models established using the SG + MSC and SG + SNV preprocessing methods exhibited the strongest estimation capability for lettuce leaf cadmium content, with Rp2 and RMSEp values of 0.92 and 1.53 mg/kg, respectively, for the testing dataset. This study demonstrated that visible–near-infrared spectroscopy has great potential in monitoring cadmium contamination in lettuce.