Using low-cost sensors, data can be collected on the occurrence and duration of overflows in each combined sewer overflow (CSO) structure in a combined sewer system (CSS). The collection and analysis of real data can be used to assess, improve, and maintain CSSs in order to reduce the number and impact of overflows. The objective of this study was to develop a methodology to evaluate the performance of CSSs using low-cost monitoring. This methodology includes (1) assessing the capacity of a CSS using overflow duration and rain volume data, (2) characterizing the performance of CSO structures with statistics, (3) evaluating the compliance of a CSS with government guidelines, and (4) generating decision tree models to provide support to managers for making decisions about system maintenance. The methodology is demonstrated with a case study of a CSS in La Garriga, Spain. The rain volume breaking point from which CSO structures started to overflow ranged from 0.6 mm to 2.8 mm. The structures with the best and worst performance in terms of overflow (overflow probability, order, duration and CSO ranking) were characterized. Most of the obtained decision trees to predict overflows from rain data had accuracies ranging from 70% to 83%. The results obtained from the proposed methodology can greatly support managers and engineers dealing with real-world problems, improvements, and maintenance of CSSs.