In this study, hydrothermal carbonization (HTC) at five temperatures (180, 200, 220, 240, and 260 °C) was applied to transform Paulownia leaves (PL) into a carbonaceous sorbent of Pb(II) from aqueous solutions. To enhance the adsorption efficiency of the obtained hydrochar (PH), subsequent alkali activation was performed using NaOH. Preliminary results of the Pb(II) adsorption (CPb = 200 mg/L) showed removal coefficients after 48 h of 73.44 mg/g, 82.37 mg/g, and 110.9 mg/g for PL, PH-220, and MPH-220, respectively. The selected hydrochar (PH-220) and modified hydrochar (MPH-220) were further investigated by scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR). The results revealed that alkali treatment changed the hydrochar structure and, thus, improved its adsorption performance. The kinetic parameters showed that the Pb(II) sorption onto MPH-220 followed a pseudo-second-order model, while the intra-particle diffusion went through two simultaneous stages. The Langmuir isotherm model best described the experimental data and indicated the value of 174.75 mg Pb(II)/g as the maximum adsorption capacity. The two possible mechanisms of Pb(II) binding were complexation and/or Pb-π electron interaction. The obtained results indicate the great potential of MPH-220 for Pb(II) removal from aqueous media and its potential utilization as an effective adsorbent for wastewater purification.