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In 1957, North Carolina established the precursor to its current district structure, and District 4 encompassed Eastern North Carolina. In 1977, District 6 was formed as a split from District 4.
Today, District 4 encompasses 25 counties in Eastern North Carolina.
Teams listed in bold also won a North Carolina or a combined North Carolina/South Carolina state tournament.
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2024 - Greenville - Tar Heel
2023 - Greenville - Tar Heel
2022 - Greenville - North State
2021 - Greenville - Tar Heel
2020 - International tournament not held due to Covid-19 pandemic
2019 - Greenville - Tar Heel
2018 - Greenville - North State
2017 - Greenville - North State
2016 - Greenville - North State
2015 - Greenville - Tar Heel
2014 - Greenville - North State (District 4 runner-up Rocky Mount also advances to the state tournament)
2013 - Greenville - Tar Heel
2012 - Greenville - Tar Heel
2011 - Greenville - Tar Heel
2010 - Greenville - North State
2009 - Greenville - North State
2008 - Greenville - North State
2007 - Greenville - North State (District 4 runner-up Greenville Tar Heel also advances to the state tournament)
2006 - Greenville - Tar Heel
2005 - Greenville - Tar Heel
2004 - Greenville - North State
2003 - Greenville - Tar Heel
2002 - Greenville - Tar Heel
2001 - Greenville - Tar Heel
2000 - Greenville - Tar Heel
1999 - Greenville - Tar Heel
1998 - Greenville - Tar Heel
1997 - Greenville - North State
1996 - Greenville - Tar Heel
1995 - Greenville - Tar Heel
1994 - Greenville - Tar Heel
1993 - Greenville - Tar Heel
1992 - Greenville - Tar Heel
1991 - Greenville - North State
1990 - Greenville - Tar Heel
1989 - Greenville - North State
1988 - Greenville - Tar Heel
1987 - Greenville - Tar Heel
1986 - Greenville - North State
1985 - Havelock
1984 - Greenville - North State
1983 - Greenville - North State
1982 - Greenville - North State
1981 - Roanoke Rapids-Weldon
1980 - Greenville - Tar Heel
1979 - Roanoke Rapids-Weldon
1978 - Roanoke Rapids-Weldon
1977 - Roanoke Rapids-Weldon
1976 - Brunswick County (Supply)
1975 - Greenville - North State
1974 - Havelock
1973 - Roanoke Rapids-Weldon
1972 - Fort Bragg
1971 - Morehead City
1970 - Greenville - Tar Heel
1969 - Havelock
1968 - Havelock
1967 - Morehead City
1966 - Havelock
1965 - Havelock
1964 - Greenville - Tar Heel
1963 - Tarboro
1962 - Greenville - Tar Heel
1961 - Greenville - North State
1960 - Warsaw
1959 - Fort Bragg
1958 - Tarboro
1957 - Greenville - Tar Heel
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1956 - Cool Springs (Forest City)
1955 - Moore County (Pinehurst)
1954 - Mooresville
1953 - Greensboro Southern
1952 - Greensboro National
1951 - North Wilmington
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