| Osgood | community in N Lee County. Inc. 1889; charter repealed 1891. Named for local family. Early known as Shakerag, traditionally because two prominent men fought there until their clothes were torn off. Alt. 242. |
| Osmond | community in NE Caswell County. A post office was operated there, 1883-1916. |
| Ossipee | community in W Alamance County on the S side of Altamahaw. Developed after 1890 when a mill was est. there. Inc. 2002. |
| Osteen | community in SW Henderson County on Crab Creek. |
| Ostin Creek | rises in W central Polk County at the base of Chimney Top and flows NE into Lake Adger on Green River. |
| Ostin Knob | SE Macon County between Brown Gap and East Fork Overflow Creek. |
| Ostwalt | community in S Iredell County. Known as Cambridge for an Associate Reformed Presbyterian Church from the early nineteenth century until 1895, when it took its present name from J. K. Ostwalt's store when it became a post office. |
| Oswego | community in NE Franklin County served by post office, 1892-1903. |
| Otaré | See Mountain Region. |
| Oteen | community in central Buncombe County near the E limits of Asheville. Site of a veterans hospital, est. during World War I for tubercular soldiers. Name said to be an Indian word meaning "chief aim" and descriptive of the hospital's efforts to restore health to the disabled. |