The cities of Greensboro, Winston-Salem, and High Point are located in the district.

After congressional reapportionment following the 2010 census, the district was shifted northward by the North Carolina General Assembly.

From then until 2017, it included portions of Guilford, Alamance, Durham, Granville, and Orange counties, and all of Caswell, Person, Rockingham, Surry, and Stokes counties.

Prior to 2022 redistricting the 6th district included all of Guilford County and part of Forsyth.

On February 23, 2022, the North Carolina Supreme Court approved a new map which changed the 6th district boundaries to also include Caswell and Rockingham Counties.