The district is currently represented by 11-term Congressman David Price, a former political science professor at Duke who was first elected in 1986, ousting one-term Republican incumbent Bill Cobey. Price was reelected in 1988, 1990, and 1992, but he was defeated in his bid for a fifth term in 1994 by Republican Fred Heineman, the Raleigh Police Chief, in a generally bad year for Democrats in North Carolina. Price came back to defeat Heineman in a rematch in 1996, and has been reelected each time since then by large margins, usually with more than 60% of the vote. In 2008, Price received 63% (265,751 votes) to defeat Republican challenger B.J. Lawson, who received 37% (153,947 votes).
According to research by Christopher Ingraham of the Washington Post, the district is the third most gerrymandered Congressional district in North Carolina and seventh most gerrymandered district in the United States.
From 2003 to 2013 it contained most of the area commonly known as The Triangle. It includes most of Durham County, all of Orange County, part of Wake County and a small section of Chatham County. The 4th district picked up the most Republican areas of Wake County, such as Apex, Cary, and much of North Raleigh in order to help make the neighboring 13th and 2nd districts more Democratic. For instance, Barack Obama defeated John McCain in the Wake County portion of the district in 2008 by 51-48%, a difference of less than 8,000 votes in between the two candidates.In contrast, Obama won Wake County overall by a much greater margin of 56-43%, and Obama swept the 4th district as a whole by 63-36%. Any Republican strength in Wake County is more than balanced out by the two Democratic strongholds of Orange and Durham Counties, where Obama received 72% and 76%, respectively, his two best counties in the entire state. The presence of the University of North Carolina-Chapel Hill and Duke University, as well as a large African-American population in Durham County help contribute to the liberal nature of the 4th district. The 4th district had a Cook PVI of D+8, which made it the most Democratic white-majority district in the entire South outside of South Florida and Northern Virginia. The district became even more heavily Democratic as a result of 2012 redistricting, in which the Republican-trending Southern and Western Wake County portions of the district were removed and replaced by heavily Democratic portions of Alamance, Cumberland, and Harnett counties. Swing areas in Northern Durham County and Northern Orange County were also removed.