| Middle Creek | rises in SW Wake County SE of the town of Apex and flows SE through Sunset Lake; it continues across S Wake County and into central Johnston County, where it enters Neuse River W of the town of Smithfield. Appears on the Collet map, 1770. |
| Middle Creek | rises in S Yancey County and flows NE into South Toe River. |
| Middle Creek Falls | on Middle Creek S of Rattlesnake Ridge, S Macon County. |
| Middle Creek Township | S Wake County. |
| Middle Elk Ridge | central Avery County. |
| Middle Falls | in Snowbird Creek between Upper Falls and Big Falls in SW Graham County. Water drops approx. 50 ft. |
| Middle Fork | rises in NW Henderson County and flows SE into Fletcher Creek. |
| Middle Fork | rises in SW Macon County and flows N into Kilby Creek. |
| Middle Fork | rises in E Madison County and flows SW into Little Ivy Creek. |
| Middle Fork French Broad River | rises in S Transylvania County and flows NW into French Broad River. |