The United States District Court for the District of North Carolina was established on June 4, 1790, by 1 Stat. 126. On June 9, 1794 it was subdivided into three districts by 1 Stat. 395, but on March 3, 1797, the three districts were abolished and the single District restored by 1 Stat. 517, until April 29, 1802, when the state was again subdivided into three different districts by 2 Stat. 156.
In both instances, these districts, unlike those with geographic designations that existed in other states, were titled by the names of the cities which the courts sat. After the first division, they were styled the District of Edenton, the District of New Bern, and the District of Wilmington; after the second division, they were styled the District of Albermarle, the District of Cape Fear, and the District of Pamptico. However, in both instances, only one judge was authorized to serve all these districts, causing them to effectively operate as a single district. The latter combination was occasionally referred to by the cumbersome title of the United States District Court for the Albermarle, Cape Fear & Pamptico District of North Carolina.
On June 4, 1872, North Carolina was re-divided into two Districts, Eastern and Western, by 17 Stat. 215. The Middle District was created from portions of the Eastern and Western Districts on March 2, 1927, by 44 Stat. 1339. Shortly thereafter, President Calvin Coolidge appointed Johnson Jay Hayes by recess appointment to be the first judge of the Middle District of North Carolina.