| COASTAL HORIZONS CENTER INC | Wilmington | F210 Mental Health & Crisis Intervention | $62.6M | 7 |
| THE V FOUNDATION | Cary | H12 Medical Research | $62.4M | 9 |
| CENTRAL ELECTRIC MEMBERSHIP | Sanford | — | $62.2M | 19 |
| Tri-County Electric Membership Corporation | Dudley | — | $61.5M | 19 |
| RURAL ECONOMIC DEVELOPMENT CENTER INC | Raleigh | S320 Community Improvement & Capacity Building | $60.7M | 12 |
| HONORBRIDGE | Greenville | G44 Diseases, Disorders & Medical Disciplines | $60.1M | 5 |
| HOSPICE OF THE EMERALD COAST INC | Mooresville | P74 Human Services | $60.1M | 3 |
| PROVIDENCE DAY SCHOOL INC | Charlotte | B200 Education | $59.7M | 13 |
| IPAS | Chapel Hill | Q300 International, Foreign Affairs & National Security | $59.3M | 10 |
| ASSOCIATED HEALTH SERVICES INC | Durham | E210 Health Care | $58.6M | 7 |
| EVERYAGE | Newton | P750 Human Services | $57.3M | 11 |
| CHARLOTTE LATIN SCHOOLS | Charlotte | B200 Education | $57.2M | 8 |
| ROANOKE ELECTRIC MEMBERSHIP | Aulander | — | $57.2M | 15 |
| PEE DEE ELECTRIC MEMBERSHIP CORP | Lilesville | — | $56.8M | 18 |
| STRATEGIC VICTORY FUND | Raleigh | — | $56.2M | 0 |
| JOHNSON C SMITH UNIVERSITY | Charlotte | B430 Education | $55.8M | 16 |
| SALL FAMILY FOUNDATION | Cary | — | $55.5M | 0 |
| CAROLINA FAMILY HEALTH CENTERS INC | Wilson | — | $55.5M | 11 |
| TIDELAND ELECTRIC MEMBERSHIP | Pantego | — | $55.1M | 17 |
| BLUE RIDGE HEALTHCARE | Morganton | E60 Health Care | $54.1M | 8 |
| MONTREAT COLLEGE | Montreat | B42Z Education | $54M | 5 |
| HOSPICE OF WAKE COUNTY INC | Raleigh | — | $53.8M | 9 |
| HAYWOOD ELECTRIC MEMBERSHIP | Waynesville | — | $53.8M | 13 |
| SRCCO | Durham | S41 Community Improvement & Capacity Building | $53.5M | 4 |
| AMERICAN BOARD OF PEDIATRICS INC | Chapel Hill | G98 Diseases, Disorders & Medical Disciplines | $52.8M | 26 |
| GOODWILL INDUSTRIES OF EASTERN NORTH CAROLINA INC | Durham | J32Z Employment | $52.1M | 10 |
| Chatham Hospital Inc | Siler City | — | $52M | 16 |
| LUTHERAN RETIREMENT MINISTRIES OF | Burlington | L11 Housing & Shelter | $51.9M | 8 |
| GLENAIRE INC | Greensboro | P750 Human Services | $51.8M | 7 |
| MARS HILL UNIVERSITY | Mars Hill | B420 Education | $51.6M | 6 |
| THE BLANCHE AND JULIAN ROBERTSON | Salisbury | T22Z Philanthropy, Voluntarism & Grantmaking Foundations | $51.5M | 1 |
| ASHE MEMORIAL HOSPITAL INC | Jefferson | E220 Health Care | $51.4M | 5 |
| Arbor Acres United Methodist Retirement Community Inc | Winstonsalem | — | $51M | 9 |
| E4E RELIEF LLC | Charlotte | M20 Public Safety, Disaster Preparedness & Relief | $50.7M | 17 |
| LUMBEE LAND DEVELOPMENT INC | Pembroke | P50 Human Services | $50.5M | 27 |
| St Lukes Hospital | Columbus | E22 Health Care | $50.4M | 10 |
| ALDERSGATE UNITED METHODIST RETIREMENT | Charlotte | — | $50.4M | 7 |
| University of Mount Olive Inc | Mount Olive | B420 Education | $50.4M | 8 |
| BARTON COLLEGE | Wilson | B420 Education | $49.9M | 6 |
| AUTHORACARE COLLECTIVE | Greensboro | P74Z Human Services | $49.6M | 12 |
| HOME HEALTH AND HOSPICE CARE INC | Goldsboro | E92 Health Care | $49.4M | 11 |
| LEGAL AID OF NORTH CAROLINA INC | Raleigh | I80 Crime & Legal-Related | $49.3M | 7 |
| NEW YORK UNIVERSITY HOSPITALS CENTER VEBA | Charlotte | Y44 Mutual & Membership Benefit | $49.1M | 1 |
| NORTH CAROLINA PERFORMING ARTS CENTER AT CHARLOTTE FOUNDATION | Charlotte | A61 Arts, Culture & Humanities | $49M | 8 |
| SOUTHMINSTER INC | Charlotte | P750 Human Services | $48.9M | 8 |
| CAROLINA MEADOWS INC | Chapel Hill | P750 Human Services | $48.7M | 9 |
| RURAL HEALTH GROUP INC | Roanoke Rapids | E60 Health Care | $48.7M | 6 |
| Friends Homes Inc | Greensboro | P750 Human Services | $48.6M | 0 |
| SKILL CREATIONS INC | Goldsboro | L20 Housing & Shelter | $48.5M | 4 |
| THE KENAN-FLAGLER BUSINESS SCHOOL | Chapel Hill | B114 Education | $48M | 7 |
