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In 1849 Forsyth County was formed from Stokes County. Stokes was formed from Surry County  in 1789 and Surry was formed from Rowan County in 1771. Rowan County was formed from Anson County in 1753. Anson County was formed from Bladen County in 1749. Bladen County was formed from New Hanover County in 1734. New Hanover County was formed from Craven County in 1729 and Craven was formed from Bath, one of the original counties,  in 1712.

Forsyth County was named in honor of Colonel Benjamin Forsyth, a native of Stokes County, who fell on the northern frontier in the War of 1812. It is in the central section of the State (known as the Piedmont) and is bounded by Guilford, Davidson, Davie, Yadkin, and Stokes counties.  The act establishing the county ordered the first court to be held at the town hall of Salem, at which time the justices were to select a place for future courts until a courthouse could be erected. Commissioners were named to select a place for the public buildings, acquire the land, and lay out a town.

In 1851 an act was passed naming the county seat Winston.

In 1879 an act was passed authorizing that Winston and Salem be combined, provided the people voted for the same.

In 1913 Winston and Salem were incorporated as one town and Winston-Salem became the county seat.