| Little Rose Creek | rises in SE Mitchell County and flows NW into Rose Creek. |
| Little Ruin Creek | rises in W Vance County and flows SE into Ruin Creek. Appears on Collet map, 1770. |
| Little Salt Rock Creek | rises in E Macon County and flows NW into Wildcat Creek. |
| Little Sam Knob | S Haywood County between Bubbling Springs Branch and Flat Laurel Creek. Alt. 5,862. |
| Little Sandy Branch | rises in S Stokes County and flows SE into Town Fork Creek. |
| Little Sandy Creek | rises in NE Wilkes County and flows S into East Prong Roaring River. |
| Little Sandy Gap | on the Buncombe-Madison county line E of Davidson Gap. |
| Little Sandy Mush Bald | peak on the Buncombe-Madison county line between Sandy Mush Bald and Chestnut Gap. |
| Little Sandy Run Swamp | rises in W Onslow County and flows SE into Sandy Run Swamp. |
| Little Sandymush Creek | rises in S Madison County and flows E into Sandy Mush Creek. |