| ACTION PATHWAYS INC | Fayetteville | P20Z Human Services | $21.6M | 2 |
| NORTH CAROLINA SYMPHONY SOCIETY INC | Raleigh | A690 Arts, Culture & Humanities | $21.5M | 8 |
| PENDER EMS AND FIRE INC | Burgaw | M24 Public Safety, Disaster Preparedness & Relief | $21.4M | 11 |
| PENICK VILLAGE INC | Southern Pines | P750 Human Services | $21.4M | 8 |
| HOSPICE OF CLEVELAND COUNTY INC | Shelby | P74Z Human Services | $21.3M | 10 |
| Cape Fear Academy | Wilmington | B200 Education | $21.2M | 7 |
| Sugar Creek Charter School Inc | Charlotte | B292 Education | $21.2M | 3 |
| GREENSBORO COUNTRY CLUB INC | Greensboro | — | $21.1M | 10 |
| EMPLOYMENT SOURCE INC | Fayetteville | P82 Human Services | $21.1M | 11 |
| FAYETTEVILLE AREA HEALTH EDUCATION FOUNDATION INC | Fayetteville | B54Z Education | $21M | 9 |
| NEW HANOVER COMMUNITY HEALTH CENTER | Wilmington | — | $21M | 10 |
| STATE EMPLOYEES CREDIT UNION FOUNDATION | Raleigh | T23 Philanthropy, Voluntarism & Grantmaking Foundations | $20.9M | 0 |
| GEORGE AND SARAH BUCHANAN FOUNDATION | Greensboro | T22 Philanthropy, Voluntarism & Grantmaking Foundations | $20.9M | 0 |
| Saint Augustine's University | Raleigh | B420 Education | $20.9M | 3 |
| NORTH RIDGE COUNTRY CLUB INC | Raleigh | — | $20.8M | 7 |
| PIEDMONT TRIAD CHARITABLE FOUNDATION D/B/A WYNDHAM CHAMPIONSHIP | Greensboro | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $20.8M | 0 |
| MARY REYNOLDS BABCOCK FOUNDATION INCORPORATED | Winstonsalem | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $20.7M | 11 |
| HOSPICE OF IREDELL COUNTY INC | Statesville | P74Z Human Services | $20.7M | 9 |
| NORTH CAROLINA RATE BUREAU | Raleigh | — | $20.7M | 8 |
| UNITED WAY OF GREATER CHARLOTTE INC | Charlotte | T700 Philanthropy, Voluntarism & Grantmaking Foundations | $20.6M | 5 |
| LIFESPAN INC | Charlotte | — | $20.5M | 4 |
| GASTON DAY SCHOOL INC | Gastonia | B200 Education | $20.4M | 2 |
| PIEDMONT ADVANTAGE CREDIT UNION | Winstonsalem | — | $20.4M | 9 |
| CAPITAL AREA SOCCER LEAGUE INC | Raleigh | — | $20.4M | 6 |
| EAST CAROLINA UNIVERSITY EDUCATIONAL FOUNDATION INC | Greenville | N110 Recreation & Sports | $20.4M | 6 |
| NORTH CAROLINA MUSEUM OF ART FOUNDATION | Raleigh | A110 Arts, Culture & Humanities | $20.3M | 5 |
| THE UNIVERSITY OF NORTH CAROLINA AT CHAPEL HILL FOUNDATION INC | Chapel Hill | B114 Education | $20.3M | 12 |
| Leadership Schools of Johnston County | Clayton | B29 Education | $20.3M | 0 |
| Nourish Up | Charlotte | P600 Human Services | $20.2M | 3 |
| Edreports Org Inc | Raleigh | B90 Education | $20.2M | 4 |
| BIBLE BROADCASTING NETWORK INCORPORATED | Charlotte | X840 Religion-Related | $20M | 9 |
| GREENE COUNTY HEALTH CARE INC | Snow Hill | E21Z Health Care | $20M | 11 |
| GIVING WITH GRACE FOUNDATION | Cornelius | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $20M | 0 |
| COMMUNITY FOUNDATION OF HENDERSON COUNTY INC | Hendersonville | T310 Philanthropy, Voluntarism & Grantmaking Foundations | $20M | 2 |
| Young Men's Christian Association of Southeastern North Carolina Inc | Wilmington | P27Z Human Services | $19.9M | 4 |
| WESTERN PIEDMONT COUNCIL OF GOVERNMENTS | Hickory | W00O Public & Societal Benefit | $19.8M | 4 |
| HopeWay Foundation | Charlotte | E12 Health Care | $19.8M | 6 |
| MERANCAS FOUNDATION INC | Charlotte | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $19.8M | 1 |
| MOVEMENT CHARTER SCHOOL | Charlotte | B29 Education | $19.7M | 3 |
| Young Men's Christian Association of Greensboro Inc | Greensboro | P27Z Human Services | $19.6M | 3 |
| CAROLINA COUNTRY CLUB COMPANY | Raleigh | — | $19.5M | 9 |
| SOUTHLIGHT HEALTHCARE INC | Raleigh | F20Z Mental Health & Crisis Intervention | $19.5M | 13 |
| FFTC PARTNERS FOR EMPOWERING COMMUNITIES | Charlotte | S31 Community Improvement & Capacity Building | $19.3M | 4 |
| PIEDMONT COMMUNITY CHARTER SCHOOL | Gastonia | B24 Education | $19.3M | 1 |
| MOUNTAIN ISLAND CHARTER SCHOOL | Mount Holly | B29 Education | $19.3M | 1 |
| Cape Fear Tutoring Inc | Wilmington | — | $19.2M | 4 |
| CHARLOTTE RESCUE MISSION | Charlotte | F220 Mental Health & Crisis Intervention | $19M | 2 |
| NORTH RALEIGH CHRISTIAN ACADEMY INC | Raleigh | B99Z Education | $19M | 2 |
| Plantation Village Inc | Wilmington | E91Z Health Care | $18.9M | 0 |
| RB TERRY CHARITABLE FOUNDATION INC | High Point | T20 Philanthropy, Voluntarism & Grantmaking Foundations | $18.9M | 6 |