Urban counties in large metropolitan areas in the United States are among the most affected by the coronavirus disease 2019 (COVID-19) pandemic, with high proportions of confirmed infection among those who have been tested. While there is growing evidence of disparities by race/ethnicity across neighborhoods, the extent to which neighborhood poverty is associated with infection and deaths is not clear. In this cross-sectional study, we examined the association of neighborhood race/ethnicity and poverty with COVID-19 infections and related deaths in urban US counties, hypothesizing disproportionate burdens in counties with a larger percentage of the population belonging to minority racial/ethnic groups and a higher rate of poverty. This study is among the first to investigate such associations in US metropolitan areas.