On April 9, 1997, First Community took over Blue Ridge Bank of Sparta, North Carolina for about $24.6 million.

Along with two branches opening in June 2003 in Winston-Salem, North Carolina, the deal gave First Community Bank 46 branches in Virginia, West Virginia and North Carolina.

[9] First Community Bancshares president and CEO John M. Mendez said Charlottesville, Hampton Roads and possibly Roanoke were other markets in which the bank planned growth.

TriStone chief executive Simpson "Skip" Brown Jr. became the First Community Piedmont Triad regional president, and the bank's North Carolina headquarters moved to the former TriStone branch on Jonestown Road.

[19] In 2014, First Community announced it would buy Bank of America branches with $440 million in deposits located in Abingdon, Blacksburg, Gate City, Hillsville, Pulaski and Wytheville in Virginia and Mount Airy in North Carolina.

[20] On December 15, 2014, 13 branches of First Community began operating as CresCom Bank after the Carolina Financial Corp. subsidiary completed a $7 million purchase.

[21][22] On March 4, 2016, First Community and First Bancorp announced a deal in which First Community would sell all three of its branches in Winston-Salem, and one each in Huntersville, North Carolina, and Mooresville, North Carolina, to First Bancorp.

With deposits totaling $150 million, these were located in Abingdon, Blacksburg, Christiansburg, Fort Chiswell, Radford, Salem and Wytheville.

[25] On November 18, 2022, Surrey Bancorp of Mount Airy, North Carolina, announced a $113.2 million deal with First Community Bank expected to be completed in the second quarter of 2023.