A case-control study of radio frequency electromagnetic fields (RF-EMFs) and childhood leukemia was conducted in West Germany. The study region included municipalities near high-power radio and TV broadcast towers, including 16 amplitude-modulated and 8 frequency-modulated transmitters. Cases were aged 0-14 years, were diagnosed with leukemia between 1984 and 2003, and were registered at the German Childhood Cancer Registry. Three age-, gender-, and transmitter-area-matched controls per case were drawn randomly from population registries. The analysis included 1,959 cases and 5,848 controls. Individual exposure to RF-EMFs 1 year before diagnosis was estimated with a field strength prediction program. Considering total RF-EMFs, the odds ratio derived from conditional logistic regression analysis for all types of leukemia was 0.86 (95% confidence interval: 0.67, 1.11) when upper (>or=95%/0.701 V/m) and lower (<90%/0.504 V/m) quantiles of the RF-EMF distribution were compared. An analysis of amplitude-modulated and frequency-modulated transmitters separately did not show increased risks of leukemia. The odds ratio for all types of leukemia was 1.04 (95% confidence interval: 0.65, 1.67) among children living within 2 km of the nearest broadcast transmitter compared with those living at a distance of 10-<15 km. The data did not show any elevated risks of childhood leukemia associated with RF-EMFs.