North Carolina Highway 45 is a primary state highway in the state of North Carolina. The highway traverses north-south, from Swan Quarter to Winton.

NC 45's southern terminus is in Swan Quarter. Heading north, it merges with U.S. 264, splits briefly, before merging with NC 99. The two highways continue north to Plymouth. From Plymouth it splits off from NC 99, and continues north, paralleling the Chowan River. Then it reaches its northern terminus at U.S. 13 just outside of Winton.