Bed bug risk in the United States concentrates heavily in a handful of states, driven by population density, housing turnover, and travel patterns rather than climate alone. Illinois, California, Michigan, Ohio, Pennsylvania, and Indiana consistently rank among the highest-risk states, with their major metro areas dominating national infestation lists year after year.
The Highest-Risk States and Cities
Orkin, one of the largest pest control companies in the U.S., publishes an annual ranking of bed bug hotspots based on treatment data. The 2026 list paints a clear picture of where infestations cluster:
- Illinois: Chicago holds the #1 spot (again), and Springfield ranks #6.
- Ohio: Cleveland (#4), Columbus (#8), and two cities in the top 10 give Ohio one of the highest concentrations of bed bug activity in the country.
- California: Los Angeles ranks #2 nationally.
- Michigan: Detroit (#3) and Grand Rapids (#10) both make the list.
- Indiana: Indianapolis comes in at #5.
- Pennsylvania: Pittsburgh holds the #9 spot.
- Washington, D.C.: Ranks #7, making the capital region another persistent hotspot.
The pattern is clear: large Midwestern and Northeastern cities with dense, older housing stock dominate. Ohio and Illinois each place multiple cities in the top 10, making them the two states with the broadest bed bug burden. California and D.C. round out the list as major travel and population hubs on the coasts.
Why These States, Not Others
Bed bugs don’t care about climate the way mosquitoes or ticks do. They live indoors, in mattresses and furniture, so temperature and humidity outside matter far less than what’s happening inside buildings. The factors that actually drive state-level risk are more about how people live and move.
Multi-unit housing is the single biggest risk multiplier. Apartments, dormitories, shelters, and hotels all create environments where occupant turnover is constant and bed bugs can spread easily between units through walls, shared laundry, and secondhand furniture. States with large urban populations living in older apartment buildings, particularly in the Midwest and Northeast, see disproportionately high infestation rates. These units also tend to be smaller and more cluttered, which makes inspection and treatment harder.
Poverty plays a significant role. Persistent bed bug problems are closely linked to the inability to afford professional extermination, which can cost hundreds or thousands of dollars. In cities where economic inequality is sharp, infestations take root and spread because they go untreated longer. International and domestic travel, particularly through high-traffic airports and hotel corridors, seeds new infestations constantly. And the modern bed bug resurgence itself traces back to less potent insecticides, increased global travel, and a general loss of the vigilance that kept populations low in earlier decades.
What Makes Multi-Unit Housing So Vulnerable
If you live in an apartment building, your bed bug risk is fundamentally different from someone in a single-family home. People and their belongings move into multi-family housing almost every day, and each new tenant, piece of used furniture, or suitcase is a potential introduction point. Once bed bugs establish in one unit, they can migrate to adjacent apartments through tiny gaps in walls, electrical outlets, and shared plumbing spaces.
This is why cities with large renter populations consistently top infestation lists. The same dynamic applies to hotels, hostels, college dorms, and shelters. Anywhere beds are shared across a rotating population, the math favors bed bugs. Southern and western states see a somewhat different treatment landscape: whole-structure fumigation is more common there because the infrastructure already exists for termite control, giving pest companies another tool in those regions.
How Renter Protections Vary by State
Your legal protections depend heavily on where you live. New York City has some of the strongest bed bug regulations in the country. Landlords there are legally required to eradicate infestations, and bed bugs are classified as a hazardous condition that must be corrected within 30 days. Building owners must also provide every new tenant with a written disclosure of the property’s bed bug history from the past year, specifying which floors were affected and whether eradication measures were taken.
Most states don’t go nearly this far. Many have no specific bed bug statutes at all, leaving tenants to rely on general habitability laws that may or may not cover pest infestations explicitly. In states without clear landlord responsibility, tenants can end up footing the bill for treatment themselves. If you’re apartment hunting in a high-risk state, asking directly about bed bug history and checking whether your state or city has disclosure requirements is worth the effort before signing a lease.
What Treatment Looks Like (and Costs)
If you do find yourself dealing with an infestation, the two main professional approaches are heat treatment and chemical treatment, and they differ significantly in cost, timeline, and effectiveness.
Heat treatment works by raising a room’s temperature to 130 to 135°F, which kills bed bugs at every life stage, including eggs. This is the key advantage: because eggs survive most chemical applications and hatch 6 to 10 days later, chemical treatment typically requires 2 to 4 visits to fully eliminate an infestation. Heat treatment usually resolves the problem in a single visit. Per-room costs run $400 to $900 for heat and $200 to $400 for chemical treatment. For a whole home, expect $1,000 to $5,000 for heat treatment or $500 to $3,000 for chemical.
The trade-off is straightforward: heat costs more upfront but works faster and more completely. Chemical treatment is cheaper per visit but requires follow-ups and patience. Neither method prevents reinfestation, so if you live in a multi-unit building where neighboring units are also affected, the problem can return regardless of what you do in your own apartment. This is why building-wide treatment plans matter more than individual unit efforts in apartment settings.
Lowering Your Personal Risk
Living in a high-risk state doesn’t guarantee you’ll encounter bed bugs, but it does mean taking basic precautions is worthwhile. When traveling, inspect hotel mattress seams and headboards before unpacking. Keep luggage on hard surfaces or luggage racks rather than on beds or carpeted floors. When returning home, running travel clothes through a hot dryer cycle for at least 30 minutes kills any hitchhikers.
If you’re moving into a new apartment in a city that ranks high on infestation lists, inspect the unit before moving furniture in. Look at mattress seams, baseboards, electrical outlet covers, and the edges of carpet. Small rust-colored spots on fabric or tiny white eggs along seams are telltale signs. Used furniture, particularly mattresses, bed frames, and upholstered couches, is one of the most common ways bed bugs enter a home. In high-risk areas, the savings from a curbside couch rarely justify the potential cost of an exterminator visit weeks later.