Bed bugs are blood-sucking insects belonging to the Cimicidae family. Some species are important in the context of public health because of their anthropophilic behavior. Currently, there has been a resurgence of bed bug infestations in various locations around the world, especially in large cities. The objective of this study was to describe the current state of bed bug infestations in the metropolitan region of São Paulo in the period 2004 to 2009. Through descriptive study based on records of occurrence of bed bugs provided by private pest control and government surveillance agencies in the Metropolitan Region of São Paulo, we registered 369 infestations of bed bugs. Cimex lectularius was the predominant species, accounting for 262 records (92.2%). The study revealed that bed bug infestations occur regularly in the metropolitan region of São Paulo. Underreporting of infestation is a reality, which minimizes the importance of the situation. The study revealed that bed bug infestations occur regularly in the metropolitan region of São Paulo.