Cadmium, an environmental toxin, is associated with a range of adverse health effects due to increased Reactive Oxygen Species production, including decreased bone mineral density and osteoporosis. Notably, cadmium is found at concentrations 4-5x higher in the blood of smokers versus non-smokers. Experiments performed in human cancer cells indicate that melatonin may directly protect against cadmium-induced tissue damage via regulation of mitochondrial activity. Further, recent evidence has demonstrated that melatonin can improve bone health for individuals with osteoporosis and partially protect against cadmium-associated inhibition of bone repair. Here we review this data and propose supplementation with melatonin as a strategy to protect against the negative impacts of cadmium exposure on bone mineral density within individuals regularly exposed to cadmium via cigarette smoking.