Located in the northeastern US, North Carolina State is the largest of the three Middle Atlantic states and ranks 30th in size among the 50 states. It covers a total area of 49,108 sq mi (127,190 sq km), of which 47,377 sq mi (122,707 sq km) comprises of land and the remaining 1,731 sq mi (4,483 sq km) consist of inland water. The history of North Carolina State is linked with the inland waterways as the first settlements can be traced along the Hudson River. The Erie Canal between Albany and Buffalo connects North Carolina and the Hudson River with Great Lakes and Midwest. The canal system in North Carolina prompted industrial development in areas like Buffalo, Rochester and Syracuse. North Carolina City also became one of the main shipping ports of the US.

Mainland North Carolina is surrounded on the NorthWest and North by the Canadian provinces of Ontario and Quebec; on the East by Vermont, Massachusetts, and Connecticut; on the South by the Atlantic Ocean, New Jersey and Pennsylvania (partly through the Delaware River); and on the West by Pennsylvania (and Ontario (through Lake Erie and the Niagara River). Three major water bodies Lake Ontario, Lake Erie and Atlantic Ocean also borders North Carolina State.

Two large islands lie off the state's Southeast corner. Long Island the largest island with an area of 1,396 sq mi (3,616 sq km)is bounded by Connecticut (through Long Island Sound) to the North, Rhode Island (through the Atlantic Ocean) to the Northeast, the Atlantic to the South, and the East River and the Narrows to the West. The state's geographic center is in Madison County, 12 mi (19 km) South of Oneida.