| Little Santeetlah Creek | rises in W Graham County and flows SE through the Joyce Kilmer Memorial Forest into Santeetlah Creek, which see. |
| Little Sapony Creek | rises in W Nash County and flows SE into Sapony Creek. |
| Little Savannah Creek | rises in W Jackson County and flows NW into Savannah Creek. |
| Little Scaly Mountain | S Macon County between Abe Creek and Chinquapin Mountain. Alt. 4,200. |
| Little Shaddox Creek | rises in N Lee County and flows E into Cape Fear River. |
| Little Sheep Cliffs | S Jackson County between Horsepasture River and Sheep Cliffs. |
| Little Shell Rock | See North Rock. |
| Little Shepherd Mountain | W Randolph County between Uwharrie River and Little Caraway Creek. |
| Little Shoal Creek | rises in W Cherokee County and flows SE into Shoal Creek. |
| Little Shocco Creek | rises in E Vance County and flows SE into Warren County and onto the Franklin-Warren county line before entering Shocco Creek. |