Middlesex is a town in Nash County, North Carolina, United States. It is part of the Rocky Mount, North Carolina Metropolitan Statistical Area. Middlesex is about 25 miles east of Raleigh, North Carolina. The population was 838 at the 2000 census.
Middlesex is located at 35°47′23″N 78°12′12″W / 35.78972°N 78.20333°W / 35.78972; -78.20333 (35.789769, -78.203428).
According to the United States Census Bureau, the town has a total area of 1.0 square miles (2.5 km²), all of it land.