| Patsy Creek | rises in NW Yancey County and flows SE into Roaring Fork. |
| Patterson | town in central Caldwell County. Founded in 1851 as the site of a textile mill. Inc. 1905, but long inactive in municipal affairs. Named for Samuel Finley Patterson (1799-1874), local resident and state official. Alt. 1,253. Patterson School operated there since 1909. |
| Patterson Branch | rises in NE Cherokee County and flows NW into Junaluska Creek. |
| Patterson Branch | rises in central Franklin County and flows SE into Fox Creek. |
| Patterson Branch | rises in E Hoke County and flows SW into Puppy Creek. |
| Patterson Branch | rises in N Yancey County and flows SE into Jacks Creek. |
| Patterson Creek | rises in NW Iredell County and flows E into Rocky Creek. Formerly known as Big Rocky Creek. |
| Patterson Creek | rises in W Lee County and flows NW into Deep River. |
| Patterson Creek | rises in S central Transylvania County and flows SE into French Broad River. |
| Patterson Springs | community in S Cleveland County. Alt. 904. Settled in the 1880s. Named for Arthur Patterson Sr., who lived near Kings Mountain at the time of the 1780 battle. |