Founded in 1817, the modern boundaries of the diocese roughly correspond to the portion of North Carolina between I-77 in the west and I-95 in the east, including the most populous area of the state.

Raleigh, Charlotte, Winston-Salem, Greensboro, and Durham are the largest cities in the diocese.

Consisting of approximately 48,000 communicants,[7] the diocese is the tenth-largest in the nation and has shown a 3% compound annual growth rate over the last ten years.

Principal programs of the diocese include campus ministries and social ministries: The diocese no longer operates a camp and conference center, having sold its facility near Browns Summit, North Carolina to the State of North Carolina for use as Haw River State Park.

Other major institutions affiliated with the diocese are Penick Village in Southern Pines, a retirement community; and Thompson Child and Family Focus in Charlotte, a youth services ministry.