[1] After making landfall in the Big Bend region of Florida on September 27, the hurricane began to traverse over land across Georgia as a Category 2 hurricane and into the Appalachian mountain range as a tropical storm, depositing record-breaking amounts of rainfall across several settlements in western North Carolina, such as Asheville, Swannanoa, Spruce Pine, Chimney Rock, Montreat, Lake Lure, and several others.

As a result of the historic rainfall, several rivers in the region overflowed and inundated multiple settlements, destroying houses and infrastructure and cutting off power, transportation, and communications to many towns for prolonged periods.

Western North Carolina, and Appalachia as a whole, has historically been victim to significant flooding and damage caused by weakened hurricanes or their remnants, despite being far inland of coastal regions that typically bear the strongest and most publicized impacts.

[2][3] For example, rainfall from Hurricane Andrew in 1992 spread across the southeastern United States along the Appalachian Mountains corridor; totals of over 5 in (130 mm) were reported near Ellicott Rock Wilderness.

[24] A unit from the 1st Battalion of the 169th Aviation Regiment, part of the Connecticut Army National Guard, was deployed to help assist disaster relief efforts.

[9] In Buncombe County, waterways associated with the French Broad River basin exceeded previous highest-ever heights by several feet, while many weather observation sites broke three-day rainfall total records.

[37] Almost the entirety of Biltmore Village and the River Arts District were flooded, and the city was largely isolated due to loss of power and cell service.

[8] A Baxter International manufacturing plant was heavily impacted by floodwaters, forcing its temporary closure and halting of the production of medications, dialysis solutions, and IV fluids for nationwide distribution.

The wind and water had tossed mobile homes hundreds of yards and washed away cars into the Catawba River, leaving the town's residents to wait for the restoration of cell service and the arrival of help from across North Carolina.

[55] Spruce Pine, the largest town in Mitchell County, was heavily inundated with 24.12 inches of rainfall and the swelling of the North Toe River, significantly damaging the downtown area and destroying several shops, roads, and connections to water and electricity.

[59] The National Weather Service stated that 19 inches of rain had fallen to the west of Lake Lure, leading to significant rising of its water levels by the morning of September 26 that caused extensive flooding.

[35] A group of 34 students and chaperones from Girard College were located by rescuers after their week long partnership with the North Carolina Outward Bound School was cut short by the storm.

[76] Operation AirDrop and the Carolina Emergency Response Team helped deploy volunteer private helicopter pilots to assist in rescue efforts.

[85] Workers and rescuers found that the animals at the Western North Carolina Nature Center were unharmed and the majority of the damage was to surrounding trees and fencing.

The state board expressed that its officials were attempting to reopen impacted election offices in order to process new voter registrations and absentee ballot requests before their deadlines pass.

These, in addition to destroyed, damaged, and blocked bridges, destruction of utilities such as power and water, and the “complete infrastructural failure” across several settlements, significantly complicated rescue efforts and aid delivery.

North Carolina Attorney General Josh Stein received over seventy complaints about the price gouging of groceries and hotel rooms, prompting him to compel businesses to provide support to those in need.

[73] On October 2, Duke Energy reported that 370 substations in western North Carolina were damaged or destroyed by the impacts of Helene, with several having been underwater.

T-Mobile also noted difficulties in restoring coverage in North Carolina due to access challenges, resorting to distributing Wi-Fi connectivity stations and mobile generators to the region.

This was a problem for an area dependent on tourists coming to see fall leaves, but the priority, Cooper said, was "meeting people's immediate needs, saving lives".

[96] Visit North Carolina warned people not to come because of power and water outages, shortages of food and gas, and closed roads.

[99] In the Asheville area, with tourism representing 20 percent of the economy and contributing $3 billion[100] in 2023, North Carolina Arboretum reopened October 28 and Biltmore Estate started its Christmas season November 2.

Buncombe County Tourism Development Authority and Explore Asheville resumed marketing, though VisitNC's Travel Advisory Map put the area under a yellow alert on October 19, meaning visitors should make sure they can get to where they want to go.

Experts stated that low-income communities would suffer the worst due to lacking substantial savings and potentially not qualifying for credit from banks or from Small Business Administration (SBA) disaster loans.

[106] In some places in Western North Carolina impacted by Helene, maps by First Street found roughly 10x the number of properties would have been in a 100-year flood zone category, if FEMA had been allowed to use more comprehensive and modern forecasting.

[106] These predictions were partly based on a 2023 study examining the aftermath of Hurricane Florence in 2018, which found that uninsured losses, when coupled with declining property values, caused significant increases in the risk of mortgage default and abandonment of housing.

[105] Governor of North Carolina Roy Cooper stated on October 1 that “The devastation brought by Hurricane Helene is beyond belief” and that, “Communities were wiped off the map.” He further reported that over 57,000 people applied for FEMA assistance.

Director of Emergency Management for North Carolina William Ray instructed people to not use drones in the area due to the potential hazards it could bring to rescue and response operations.

Vance called the hurricane's impact “an unbelievable, unspeakable human tragedy” and stated that both he and Democrat Tim Walz "want as robust and aggressive as a federal response as we can get to save as many lives as possible.

[8] Eric Church and Luke Combs put together the "Concert for Carolina" on October 26, 2024 at Bank of America Stadium in Charlotte, which raised over $24 million for hurricane relief.