| THE EZRAH CHARITABLE TRUST | Charlotte | T22 Philanthropy, Voluntarism & Grantmaking Foundations | $29.3M | 1 |
| PACE OF GUILFORD AND | Greensboro | E70 Health Care | $29.2M | 4 |
| LAKE NORMAN CHARTER SCHOOL | Huntersville | B24 Education | $29.2M | 1 |
| CORPORATE CHAPLAINS OF AMERICA INC | Wake Forest | X99Z Religion-Related | $29.1M | 9 |
| CARY ACADEMY | Cary | B250 Education | $29M | 8 |
| STATE CHARTERED CREDIT UNIONS IN NORTH CAROLINA | Canton | — | $28.9M | 7 |
| US NATIONAL WHITEWATER CENTER INC | Charlotte | N32 Recreation & Sports | $28.8M | 7 |
| WESTERN CAROLINA COMMUNITY ACTION | Hendersonville | P200 Human Services | $28.7M | 5 |
| 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 |
| WAKE COUNTY SMART START INC | Raleigh | B210 Education | $27.9M | 3 |
| Carolina Dealerships Inc Welfare Benef | Winstonsalem | Y43 Mutual & Membership Benefit | $27.8M | 0 |
| HOSPICE OF THE PIEDMONT INC | High Point | — | $27.8M | 9 |
| 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 |
| AUTISM SOCIETY OF NORTH CAROLINA | Raleigh | — | $27.7M | 8 |
| TRIANGLE RESIDENTIAL OPTIONS FOR | Durham | — | $27.7M | 7 |
| Access East Inc | Greenville | E02 Health Care | $27.6M | 14 |
| Members Credit Union | Winston Salem | — | $27.4M | 7 |
| UNIVERSITY OF NORTH CAROLINA AT CHAPEL H | Chapel Hill | B114 Education | $27.4M | 0 |
| PITT AND GREENE ELECTRIC MEMBERSHIP | Farmville | — | $27.4M | 15 |
| COLLEGE FOUNDATION INC | Raleigh | — | $27.3M | 12 |
| The Arc of North Carolina Inc | Raleigh | P730 Human Services | $27.3M | 2 |
| EAST CAROLINA UNIVERSITY EDUCATIONAL | Greenville | N110 Recreation & Sports | $26.7M | 6 |
| SALEM ACADEMY AND COLLEGE | Winstonsalem | B420 Education | $26.7M | 11 |
| 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 |
| NORTH CAROLINA LEARNS INC | Durham | B29 Education | $26.4M | 0 |
| THE NORTH CAROLINA AGRICULTURAL | Raleigh | E114 Health Care | $26.2M | 11 |
| The Cypress of Charlotte Club Inc | Charlotte | L22 Housing & Shelter | $26M | 5 |
| WILLIAM PEACE UNIVERSITY | Raleigh | B410 Education | $26M | 7 |
| THE COMMUNITY FOUNDATION | Asheville | T310 Philanthropy, Voluntarism & Grantmaking Foundations | $25.9M | 8 |
| FORSYTH COUNTRY DAY SCHOOL INC | Lewisville | B200 Education | $25.8M | 7 |
| DreamKey Partners Inc | Charlotte | L210 Housing & Shelter | $25.7M | 7 |
| Wake Preparatory Academy | Wake Forest | B29 Education | $25.5M | 0 |
| The Methodist Home for Children Inc | Raleigh | P730 Human Services | $25.5M | 7 |
| EDUCATIONAL FOUNDATION | Chapel Hill | B820 Education | $25.4M | 5 |
| TRIANGLE SPORTS COMMISSION | Morrisville | N40 Recreation & Sports | $25.3M | 0 |
| Z SMITH REYNOLDS FOUNDATION INC | Winstonsalem | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $25.2M | 16 |
| NORTH CAROLINA FOR QUALITY VIRTUAL | Durham | B29 Education | $25.1M | 1 |
| NATIONAL COLLEGE ADVISING CORPS INC | Raleigh | B80 Education | $25M | 10 |
| DAVIDSON WATER INC | Welcome | — | $25M | 21 |
| ECONOMIC IMPROVEMENT COUNCIL INC | Edenton | P20Z Human Services | $24.9M | 2 |
| GREENE COUNTY HEALTH CARE INC | Snow Hill | E21Z Health Care | $24.8M | 11 |
| LIFE ST JOSEPH OF THE PINES INC | Fayetteville | — | $24.7M | 12 |
| UNION ACADEMY | Monroe | B29 Education | $24.7M | 4 |
| Winston Salem Industries for the Blind Inc | Winstonsalem | J33Z Employment | $24.4M | 14 |
