We have followed a birth cohort from 2008 to 2009 near a dioxin-contaminated area of Da Nang, Vietnam, and investigated the effects of perinatal dioxin exposure on neurodevelopment from infancy to pre-school age. The present study aimed to investigate the effects of perinatal dioxin exposure on the learning abilities of the elementary-school children from the Da Nang birth cohort.From 241 mother-infant pairs recruited at baseline (134 boys and 107 girls), 185 (76.8%) participated in a follow-up when the children were 8 years of age (108 boys and 77 girls). The children's perinatal dioxin exposure was estimated using the dioxin levels in their mothers' breast milk. The Colorado Learning Difficulties Questionnaire (CLDQ) was used to evaluate the children's learning difficulties. Math- and language-achievement scores were obtained using paper-based tests. Reading fluency was examined by having the children read passages in Vietnamese.In boys exposed to high levels of 2,3,7,8-tetrachlorodibenzodioxin (2,3,7,8-TetraCDD), CLDQ reading scores were significantly higher (worse), and language achievement scores were significantly lower. Boys exposed to high levels of 2,3,7,8-TetraCDD as well as high levels of the toxic equivalent (TEQ) of polychlorodibenzodioxins and polychlorodibenzofurans (PCDDs/Fs) had higher numbers of reading errors. Reading errors were higher and math achievement scores were lower with increasing concentrations of 1,2,3,4,7,8-HexaCDD and 1,2,3,4,6,7,8-HeptaCDD. In girls, no significant differences of any learning ability markers were found between high and low exposure groups to TEQ-PCDDs/Fs and these 3 congeners.Perinatal dioxin exposure may have adverse effects on the learning abilities of school children, especially boys.