To better protect the nation’s wetlands and streams, the Clean Water Act allows use of compensatory mitigation to replace the benefits of lost wetlands and streams. This study summarizes North Carolina’s use of preservation for compensatory mitigation by private mitigation banks and a state-operated in-lieu fee (ILF) program. Within private mitigation banks, preservation activities have generated 5.6% of wetland credits and 9.1% of stream credits since 2008. Within the state in-lieu fee program run by the Division of Mitigation Services, 45.0% of wetland credits and 6.2% of stream credits have resulted from preservation. However, a majority of the wetland credits generated by preservation in the ILF program came from one site described as unusually large by program staff. Since 2008, North Carolina’s ILF program and mitigation banks have continued to use preservation at relatively low rates for both wetland and stream mitigation. Mitigation providers have stated that the clarity of the state’s preservation policy makes it easier for preservation to be included in projects in North Carolina than in projects in some other states. Notably, between 2012 and 2015, no wetland preservation was used for mitigation by the ILF program.