| Othello | community in SE Ashe County. |
| Otis | community in NE Yadkin County served by post office, 1891-1903. |
| Ottanola | community in NE Henderson County. |
| Ottaray | See Mountain Region. |
| Otter Creek | rises in E Alamance County and flows S into Quaker Scrub Creek. |
| Otter Creek | rises in E Craven County and flows N into Neuse River. |
| Otter Creek | rises in NW Macon County and flows SW into Whiteoak Creek. |
| Otter Creek | rises in N Rutherford County and flows SE into Cove Creek. |
| Otter Creek | rises in E Wilson County and flows E across S Edgecombe County into W Pitt County, where it enters Tar River. |
| Otter Creek | community in N Rutherford County on Cove Creek. A post office was there, 1854-1915. |