| GOODWILL INDUSTRIES OF CENTRAL NORTH CAR | Greensboro | J32Z Employment | $29.8M | 9 |
| OPPORTUNITIES INDUSTRIALIZATION CENTER INC | Rocky Mount | — | $29.7M | 13 |
| YOUNG MEN'S CHRISTIAN ASSOCIATION OF WESTERN NORTH CAROLINA | Asheville | — | $29.7M | 8 |
| TR Aqua Via Corp C/O Barings LLC | Charlotte | S47 Community Improvement & Capacity Building | $29.6M | 1 |
| CHOWAN UNIVERSITY | Murfreesboro | B30 Education | $29.6M | 11 |
| CORPORATE CHAPLAINS OF AMERICA INC | Wake Forest | X99Z Religion-Related | $29.4M | 9 |
| EDDIE AND JO ALLISON SMITH FAMILY FOUNDATION INC | Greenville | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $29.4M | 0 |
| CROSSNORE COMMUNITIES FOR CHILDREN | Crossnore | F330 Mental Health & Crisis Intervention | $29.4M | 10 |
| THE EZRAH CHARITABLE TRUST | Charlotte | T22 Philanthropy, Voluntarism & Grantmaking Foundations | $29.3M | 1 |
| GREATER RALEIGH AREA CHRISTIAN EDUCATION INC | Raleigh | B20Z Education | $29.3M | 2 |
| INTER-FAITH FOOD SHUTTLE | Raleigh | P20Z Human Services | $29.2M | 2 |
| US NATIONAL WHITEWATER CENTER INC | Charlotte | N32 Recreation & Sports | $28.8M | 7 |
| WESTERN CAROLINA COMMUNITY ACTION INC | Hendersonville | P200 Human Services | $28.7M | 5 |
| MOUNTAIN COMMUNITY HEALTH PARTNERSHIP INC | Bakersville | E32Z Health Care | $28.7M | 10 |
| SOUTHERN VISION ALLIANCE | Durham | W99 Public & Societal Benefit | $28.4M | 6 |
| CHARLOTTE COUNTRY CLUB INC | Charlotte | — | $28.3M | 13 |
| GENERATIONED | Greensboro | P33Z Human Services | $28.2M | 6 |
| Amity Medical Group Inc | Charlotte | B82 Education | $28.1M | 11 |
| LAKE NORMAN CHARTER SCHOOL | Huntersville | B24 Education | $28.1M | 1 |
| WAKE COUNTY SMART START INC | Raleigh | B210 Education | $27.9M | 3 |
| NORTH CAROLINA FOR QUALITY VIRTUAL EDUCATION INC | Durham | B29 Education | $27.8M | 1 |
| Samaritan Housing Foundation Inc | Cary | P75 Human Services | $27.8M | 14 |
| MASONIC AND EASTERN STAR HOME OF NORTH CAROLINA INC | Greensboro | P750 Human Services | $27.8M | 6 |
| HOSPICE OF THE PIEDMONT INC | High Point | — | $27.8M | 9 |
| HIGH COUNTRY COMMUNITY HEALTH INC | Boone | E30 Health Care | $27.8M | 13 |
| Charles A Cannon Jr Memorial Hospital Inc | Linville | E220 Health Care | $27.7M | 5 |
| PACE OF THE SOUTHERN PIEDMONT INC | Salisbury | P20 Human Services | $27.7M | 6 |
| Access East Inc | Greenville | E02 Health Care | $27.6M | 14 |
| STATES NEWSROOM | Chapel Hill | A30 Arts, Culture & Humanities | $27.5M | 6 |
| MCLEOD CENTERS FOR WELLBEING | Charlotte | F22Z Mental Health & Crisis Intervention | $27.4M | 7 |
| Members Credit Union | Winston Salem | — | $27.4M | 7 |
| UNIVERSITY OF NORTH CAROLINA AT CHAPEL H ARTS & SCIENCES FOUNDATION | Chapel Hill | B114 Education | $27.4M | 0 |
| PITT AND GREENE ELECTRIC MEMBERSHIP CORPORATION | Farmville | — | $27.4M | 15 |
| COLLEGE FOUNDATION INC | Raleigh | — | $27.3M | 12 |
| The Arc of North Carolina Inc | Raleigh | P730 Human Services | $27.3M | 2 |
| InReach | Charlotte | P73Z Human Services | $27.2M | 5 |
| FORSYTH COUNTRY DAY SCHOOL INC | Lewisville | B200 Education | $27M | 8 |
| The Summit School Incorporated | Winston Salem | B24Z Education | $26.9M | 4 |
| CENTRAL PIEDMONT COMMUNITY COLLEGE FOUNDATION INC | Charlotte | B110 Education | $26.7M | 5 |
| CHARLOTTE CHRISTIAN SCHOOL | Charlotte | — | $26.7M | 8 |
| THE AMERICAN BOARD OF ANESTHESIOLOGY INC | Raleigh | G91D Diseases, Disorders & Medical Disciplines | $26.6M | 23 |
| GiveClear Foundation | Charlotte | T30 Philanthropy, Voluntarism & Grantmaking Foundations | $26.5M | 2 |
| BLACKWELDER FAMILY FOUNDATION | Greenville | T12 Philanthropy, Voluntarism & Grantmaking Foundations | $26.5M | 0 |
| ASHEVILLE SCHOOL INC | Asheville | B250 Education | $26.3M | 7 |
| The Cypress of Charlotte Club Inc | Charlotte | L22 Housing & Shelter | $26M | 5 |
| The North Carolina A&T Real Estate Foundation Inc | Greensboro | B820 Education | $26M | 5 |
| WILLIAM PEACE UNIVERSITY | Raleigh | B410 Education | $26M | 7 |
| THE COMMUNITY FOUNDATION OF WESTERN NORTH CAROLINA INC | Asheville | T310 Philanthropy, Voluntarism & Grantmaking Foundations | $25.9M | 8 |
| THE NORTH CAROLINA AGRICULTURAL FOUNDATION INC | Raleigh | E114 Health Care | $25.9M | 7 |
| Economic Improvement Council Inc | Edenton | P20Z Human Services | $25.8M | 2 |
