| Old Mattie Ridge | NE Cherokee County in the Snowbird Mountains. |
| Old Mattie Top | on the Cherokee-Graham county line in the Snowbird Mountains. |
| Old Mill Creek | rises in N central Washington County in East Dismal Swamp NE of the town of Roper and flows NW into Kendricks Creek. |
| Old Mill Swamp | rises in N Sampson County and flows SE into Great Coharie Creek. |
| Old Paddy Creek | about 7/10 mi. long, rises at Paddy Creek Dam on Lake James and flows E into Old Catawba River in W Burke County about 9 mi. W of Morganton. |
| Old Richmond Township | NW Forsyth County. Named for the former town of Richmond, which see, seat of Surry County from 1774 to 1789. |
| Old Road Gap | on the Cherokee-Macon county line. |
| Old Road Ridge | N Mitchell County between Spring Creek and Greasy Creek. |
| Old Rock | See Shell Castle. |
| Old Rocky Mountain | E Macon County between the head of Ellijay Creek and the head of Little Salt Rock Creek. Alt. 4,825. |