Conference Carolinas has a rich tradition in roots that dates back to its inception on Dec. 6, 1930. The conference was formed then as an athletic association "for the greater advantage of the small colleges in North Carolina."

The official name given back then was the North State Intercollegiate Conference, but it was known informally as the Old North State Conference. 

The birthplace was the Washington Duke Hotel in Durham, N.C. and the seven charter and founding members were Appalachian State, Atlantic Christian (now Barton College), Catawba, Guilford, Elon, High Point and Lenoir-Rhyne. 

The conference followed a policy of expansion for a period of time. Western Carolina became a member in 1933, East Carolina in 1947, Pfeiffer in 1960, Newberry in 1961 and Presbyterian in 1964, followed closely by Mars Hill.

With the acceptance of the first member from South Carolina in Newberry College, a name change became necessary. On May 20, 1961 the official name of the conference was changed to the Carolinas Intercollegiate Athletic Conference (CIAC), but it was commonly known less formerly as the Carolinas Conference.    

East Carolina resigned in 1962 to join the NCAA Division I Southern Conference and Appalachian State and Western Carolina followed. Football sponsorship in Carolinas Conference was dropped when Lenoir-Rhyne, Newberry, Presbyterian and Mars Hill joined the South Atlantic Conference.

Pembroke State University (now UNC Pembroke) became a first-time member in 1976 followed by Wingate College in 1979. Lenoir-Rhyne rejoined in 1984. While Guilford College withdrew in 1988, St. Andrews and Mount Olive were added that same year.

The 1989-90 academic year started a new era as Catawba, Elon, Lenoir-Rhyne and Wingate all withdrew to compete in the first year that the NCAA Division II South Atlantic Conference would provide championships in all sports.

The Carolinas Conference then added Belmont Abbey in 1989, Coker College in 1991 and Lees-McRae in 1993.

The 1993-94 academic year brought a change to the conference's national affiliation. The conference entered dual membership into both the NAIA and NCAA Division II. 

The 1995-96 year brought dramatic change to the conference. First, full membership into NCAA Division II was acquired. The 1995-96 academic year was the first official year of full competition and championship play for the conference in NCAA Division II status. Secondly, this was also the same year that Erskine, Longwood and Queens were accepted as full members of the conference.

With Longwood becoming the first Virginia member, another name change occurred and the Carolinas-Virginia Athletics Conference (known more universally as the "CVAC") was born.    

Following the 1997 academic year High Point resigned to join the NCAA Division I ranks while in 1998 Limestone soon joined. They were quickly followed by Anderson in 1999.

In 2003, Longwood University left the conference to explore possibilities in NCAA Division I. Then in 2005 the CVAC added Converse College as an associate member. Converse became a full member starting in the 2007-08 season.

With the lone Virginia school in Longwood leaving, the league decided to go back to their roots and change their name to Conference Carolinas in 2007. 

On June 1, 2011, King College and North Greenville University became official members of the conference and opened the conference to its first Tennessee member in King.

Southern Wesleyan joined the league officially as a full NCAA Division II member on July 1, 2016 after going through the national membership process with Conference Carolinas. The league opened up their sponsorship to Southern Wesleyan where the Warriors played a full conference regular season schedule for three years (2013) prior to full NCAA Division II membership.

Emmanuel College joined Conference Carolinas July 13, 2018 after also going through the full NCAA Division II membership process. Within that process, the Lions played five years (2013) in which their games counted towards regular season standings without eligibility for league championships. 

Chowan University became a full Conference Carolinas member starting in the 2019-20 academic year. Chowan was an associate member for the sports of men's & women's lacrosse, women's golf, men's & women's soccer, baseball, men's & women's swimming and men's & women's tennis before joining Conference Carolinas from the CIAA. 

UNC Pembroke rejoined Conference Carolinas along with first-time member Francis Marion with the start of the 2022-23 academic year. 

Member institutions for the 2023-24 academic year are Barton, Belmont Abbey, Chowan, Converse, Emmanuel, Erskine, Francis Marion, King, Lees-McRae, Mount Olive, UNC Pembroke, North Greenville, Southern Wesleyan and Young Harris.

The addition of Young Harris was officially announced in November of 2022. The Mountain Lions competed in Conference Carolinas for the first time during the 2023-24 academic year. 

Shorter accepted an invitation to join the league in January of 2023 and officially began competition in Conference Carolinas in the 2024-25 academic year. 

The addition of Shorter also allowed Conference Carolinas to sponsor football as a conference sport for the first time since 1974-75. The conference officially started sponsoring football in the 2025-26 academic year.

Ferrum accecpted an invitation to join the league in April of 2024 and officially began competition in 2025-26 as the league's seventh football member.

Conference Carolinas football featured Barton, Chowan, Erskine, Ferrum, North Greenville, UNC Pembroke and Shorter in the 2025 season.

In 2025-26 Conference Carolinas boasted with the most members in its history, 16, and sponsors 30 sports. Four of those sports are in partnerships with other conferences, the second-most in all NCAA Divisions behind the Ivy League.

Many institutions have been members of the league during its rich history overall, including Anderson, Appalachian State, Barton (formerly Atlantic Christian), Belmont Abbey, Catawba, Chowan, Coker, Converse, East Carolina, Emmanuel, Erskine, Elon, Francis Marion, Guilford, High Point, King, Lees-McRae, Lenoir-Rhyne, Limestone, Longwood, Mars Hill, Mount Olive, Newberry, North Greenville, Pembroke State/UNC Pembroke, Pfeiffer, Presbyterian, Queens, Southern Wesleyan, St. Andrews, Western Carolina and Wingate.   

Barton is the only remaining charter member followed in longevity by Mount Olive joining in 1988.