As early as 1756, a church in southern Wake County was named Middle Creek Primitive Baptist Church. This church is the oldest existing church organization in Wake County. Ostensibly, it was named after a creek rising in southwestern Wake County southeast of the town of Apex, and flowing southeast through Sunset Lake, continuing across southern Wake County and into central Johnston County, where it enters Neuse River west of the town of Smithfield. Originally, the church was named Three Creeks Church after Black Creek, Middle Creek, and Swift Creek - all appearing on maps dating back to 1770.

In 1805, when Wake County justices divided the county into 21 districts, number 15 was named Middle Creek. The towns of Fuquay and Varina were later incorporated in the township. Middle Creek High School is the only high school in the district named after one of the 21 original townships in Wake County.

The school is organized around a central commons, which serves as the dining room and the social center of the school. The administrative offices, guidance offices, auditorium, media center and gymnasium are centered directly from the commons area, which facilitates way-finding and allows the commons to serve as lobby for all major events. The main entrance of the academic wing also forms the commons, but the classrooms are separated from the commons by the media center and the fire stairs that provide a noise buffer to the activity areas. The vocational classrooms are fully integrated into the three story classroom wings. The science classrooms "hinge to" two wings. The design of the academic wings promotes the integration of all disciplines in the school.

The site plan includes expansion of its recreational/cultural facilities: new soccer fields, playground areas, outdoor volleyball courts, a detached community library, and a fire station. The development of Jamison Park, a residential development connected to the park, includes a site for multi-family housing. The planning stage included the possibility of offering to teachers incentives to live in the apartments or town homes to be developed.