The fire started around 11 p.m. Thursday at a house on Stokes Street near Queens Street in Rocky Mount.
The oldest child, 14, was able to get her 12, 6, 3 and 11 month old siblings out of the house, but was unable to rescue her 5-year-old sister.
Within minutes of fire crews arriving, they were able to find the 5-year-old girl and get her out of the burning home.
The girl was taken to Nash Healthcare Systems and then was transferred to the UNC Burn Center in Chapel Hill for treatment.
The fire chief said the cause of the fire was unattended cooking in the kitchen. An investigation is ongoing at this time.
The Red Cross has been called in to help the family.