North Carolina's 5th congressional district covers the central western portion of North Carolina from the Appalachian Mountains to the northern suburbs of the Piedmont Triad as well as the bulk of the city of Greensboro.

The district borders Tennessee and Virginia, with the bulk of its territory in the mountains; it stretches just far enough to include much the of Greensboro metro.

Large portions were controlled by Republicans even during the "Solid South" era as much of northwestern North Carolina was Quaker[3] or mountaineer and therefore resisted secession.

For the 2024 election the district has been updated per Senate Bill 757[5] enacted by the NC General Assembly on October 25, 2023, becoming Session Law 2023–145.

[21] The district of Mero consisted of the counties of Davidson, Sumner and Tennessee.