Rocky Mount is a city in Edgecombe and Nash counties in the Atlantic coastal plain region of the U.S. state of North Carolina. The city's population is estimated to be 53,922 as of 2019. It is the principal city of the Rocky Mount metropolitan area, often called the "Twin Counties", which had an estimated population of 146,021 in 2018. Rocky Mount is also an anchor city of the Rocky Mount-Wilson-Roanoke Rapids Combined Statistical Area in northeast North Carolina with a total population of 297,726 as of 2018.Incorporated in 1867, the community at the falls of the Tar River that became the city of Rocky Mount dates from the middle of the 1700s. Historically strong in rail transportation, textiles, and agriculture, the economy of Rocky Mount has diversified into biomedical pharmaceuticals, manufacturing, and logistics. Forbes ranked the city as No. 6 for cost of doing business on its list of "Best Small Places For Business And Careers" in 2018. Rocky Mount has also twice received the All-America City Award from the National Civic League in 1969 and 1999.