Bed bugs have reestablished as pests over the last two decades after a period of near eradication throughout large portions of the world. The increasing frequency of bed bug infestations has prompted research into every facet of bed bug biology. Of particular interest is identification ofthe specific factors that allow bed bugs to be transported, to thrive within human dwellings and to survive pest control strategies. This review provides a synopsis ofthe biochemical, physiological and molecular mechanisms that contribute to the resurgence of bed bugs, with a focus upon the aspects that allow bed bugs to overcome the roadblocks preventing establishment and persistence in close proximity to humans. Topics discussed include dispersal, host avoidance, mating, chemical signaling, symbiosis, blood feeding, thermal tolerance, starvation resistance, dehydration resistance and pesticide resistance. These aspects of Cimex biology are explored within the context of the effect that these traits have upon transportation, establishment and eradication of bed bugs with an emphasis on the issues of pesticide resistance and population resurgence. In general, bed bugs are exceptional in their abihty to proliferate in close-proximity to humans. The emergence of recent adaptations such as pesticide resistance has exacerbated the already difficult task of eliminating bed bug infestations.