Baylisascaris procyonis is an intestinal nematode of raccoons (Procyon lotor) that can cause fatal larva migrans in numerous species of birds and mammals, including humans. Historically, this parasite has been rare in the southeastern USA but recently has been reported in eastern Tennessee and isolated parts of Georgia and Florida. The objective of the current study was to investigate the distribution and prevalence of B. procyonis in raccoons from North Carolina. In western North Carolina, in counties bordering Tennessee, B. procyonis was detected in nine of 74 (12 %) raccoons sampled in 2010-2011. In general, worm burdens (average 20 worms) were low, but one raccoon had 122 adult worms. No difference was noted in prevalence by year or age, but significantly more males were infected compared with females. Sequences of the internal transcribed spacer 2 region from three samples were identical to B. procyonis. In central North Carolina (Guilford County), all 34 raccoons and 49 fecal samples tested were negative. Collation of data from previous studies conducted in the Southeast indicates that B. procyonis has been reported from numerous counties, but surveillance has been patchy and many negative results are >30 years old. These results indicate that B. procyonis is established in North Carolina and given the zoonotic and wildlife health implications of this parasite, additional surveillance in North Carolina and other southeastern states is warranted.