| Middle Swamp | rises in N Gates County and flows E into Duke Swamp. |
| Middle Swamp | rises in N Greene County and flows SE on the Greene-Pitt county line into Little Contentnea Creek. |
| Middle Top | W Haywood County between Walker Bald and Germany Cove. Alt. 5,165. |
| Middle Township | former township in central Chowan County, now township no. 2. |
| Middle Trail Ridge | SW Macon County between Little Indian Creek and Nichols Branch. |
| Middle Watch Creek | See Salem Creek. |
| Middleburg | town in E Vance County between Mill Creek and Fishing Creek. Alt. 489. Inc. 1880; named for the fact that it was midway between the terminals of the Raleigh and Gaston Railroad. |
| Middleburg-Nutbush Township | E Vance County. Two separate townships were merged in 1965. |
| Middlesex | town in SW Nash County, settled about 1907. Inc. 1908. Named for the English city. Produces apparel. Alt. 255. |
| Middleton Creek | rises in SE Chowan County and flows NE into Yeopim River. |