NC 46 is a north/south state highway in eastern North Carolina; it is entirely in Northampton County. The route primarily connects the communities on the north side of Roanoke Rapids Lake and Lake Gaston, as well as the north side of the Roanoke River in the county.

From its eastern terminus at united states 301 in Garysburg, NC 46 travels southwest, meeting an interchange with I-95 on its way to Gaston. After crossing NC 48 and passing through the heart of the Gaston, NC 46 continues westerly along the north shore of Lake Gaston to the NC/VA state line, where NC 46 ends and VA 46 continues.

NC 46 was created between 1929 and 1930. The routing has changed very little since that time, but its eastern terminus used to be signed as US 17-1/US 117/NC 48/NC 481.

The entire route is in Northampton County