In early 1919 the North Carolina Legislature passed "An act to benefit the moral, mental, or physical condition of the inmates of penal and charitable institutions." While the law was cast as a benefit to institutionalized people, the law actually empowers "the medical staff of any penal or charitable hospital or institution of North Carolina" to have "any surgical operation performed." As seen in Iowa, the law also established a board for evaluating sterilization recommendations (NC 1919 public laws – Ch.281 Sec.4). 

While the 1919 law provided for a state eugenics board, the State did not establish the board until there was additional legislation in 1929 and funding in place. The work of the board began officially in 1933. Notably, the 1929 legislation dropped the language of patient benefit and instead focused on the provision resources to support the work of the board and institutional medical staff (NC Public Laws and Resolutions 1929 Ch 34).

In 2013 North Carolina became the first state to pass legislation compensating living survivors of eugenic sterilization programs in the state. This legislative act was a model for subsequent compensation efforts in Virginia and California.