Since at least 1715, the Lords Proprietors deemed it neccesary to appoint a Treasurer to support their appointed governors. The first documented Treasurer for North Carolina was Edward Moseley, who was appointed by the House of Burgesses in 1715 to serve Governor Charles Eden. There may have been others earlier, but available records have not identified any.

In 1740, under Royal Governor Gabriel Johnston, the Treasurer's Office was divided into two districts, and this continued after the first State Constitution was issued in 1776. In 1779, the General Assembly voted to expand the Office into six districts, then into seven districts in 1782. However, in 1784, the General Assembly consolidated the Office back to a single individual.

Per the 1776 State Constitution, the two State Treasurers were elected by the General Assembly. Since the 1868 State Constitution, the State Treasurer is elected by the people of North Carolina every four years. The State Treasurer is also on the Council of State and serves as an ex officio member of the State Board of Education, the State Board of Community Colleges, and the State Banking Commission. Powers and duties of the State Treasurer are set forth in the Constitution and Article III, Section 7 of the General Statutes of North Carolina.

As the chief financial officer and official banker, the State Treasurer bears responsibility for managing the finances of the entire State. This includes, but is not limited to:

- Managing a $74.2 billion pension fund
- Administering teacher, state employee, and local government pension plans
- Operating and managing a $12 billion state bank
- Managing state and local debt issuance and interfacing with bond rating agencies
- Overseeing the finances of local governments
- Serving as a fiscal advisor to the state
- Managing the unclaimed property program
- Administering $4 billion 401(k)/457 plans
- Administering the state disability program

The Financial Operations Division keeps record of and reports on all funds that are deposited, invested, or disbursed through the treasurer's office. The staff of this division also fulfill the treasurer's role at state banker. There are four sections within this division: banking operations, bank reconciliation, statewide accounting operations, and departmental accounting.

The Investment Management Division handles all investments on behalf of the treasurer. The staff oversee the state's cash management, pension fund investment, and ancillary investment programs.

The Retirement Systems Division manages the retirement and benefit plans for public employees, including teachers, state employees, local government employees, judges, legislators, firemen, rescue squad workers, and national guardsmen. The division also administers disability income plans, supplemental pension plans, and registers of deeds' supplemental pension funds.

The State & Local Government Finance Division manages the sale and delivery of all state and local debt, and ensure the repayment of government debt. There are three sections within this division: debt management, fiscal management, and capital facilities finance.

The Unclaimed Property Division works to return unclaimed property to its rightful and legal owner.