We examined bed bug prevalence in 2,372 low-income apartments within 43 buildings in four New Jersey cities using a combination of resident interviews, brief visual inspections, and monitoring with Climbup Insect Interceptors. Infestation rates ranged from 3.8 to 29.5% among the buildings, with an overall infestation rate of 12.3%. Within each apartment, the bed area trapped significantly more bed bugs per trap than the sofa (or upholstered chair) area. African American residents had a proportionally higher number of bed bug infestations than white residents. Women were more likely to report bed bug bite symptoms than men. Only 68% of the residents who experienced bed bug infestations reported symptoms after being bitten (n = 475). Among those with self-reported symptoms (n = 319), the frequency of the reported symptoms was: pain 90%, itchiness 20%, welts 13%, and insomnia 8%. Fifty-nine percent of the residents (n = 539) who experienced bed bug infestations applied insecticides to control bed bugs. Climbup interceptors detected 89 ± 1% and brief visual inspections detected 72 ± 3% of the infestations. Only two out of 291 infestations were not detected by brief visual inspection or interceptors. Assuming US$50 per hour labor rate, the average per apartment cost for the building-wide bed bug monitoring protocol was US$12 per apartment. Forty-nine percent of the infestations detected by the protocol were in apartments whose residents were unaware of the bed bug activity.