Starting October 2022, the Boston Public Health Commission implemented a neighborhood-level wastewater-based epidemiology program to inform strategies to reduce COVID-19 inequities. We collected samples twice weekly at 11 neighborhood sites, covering approximately 18% of Boston, Massachusetts's population. Results from the program's first year revealed inequities unobservable in regional wastewater data both between the City of Boston and the greater Boston area and between Boston neighborhoods. We report program results and neighborhood-specific recommendations and resources to help residents interpret and use our findings. (Am J Public Health. 2024;114(11):1217-1221. https://doi.org/10.2105/AJPH.2024.307749).