Police said it happened Sunday evening on Buffaloe Road near Highway 70 in Johnston County.
Officials said the pickup truck turned in front of the motorcycle, which hit the driver's door.
The North Carolina Highway Patrol said the truck driver, 84-year-old Ralph Rose of Smithfield, died at the scene.
Officials said the man driving the motorcycle, 45-year-old Rickey Mooneyhan of Selma, also died at the scene. His passenger, 36-year-old Jennifer Sabato, was taken to WakeMed hospital in Raleigh and died early Monday.
The patrol said all three victims died from trauma. Troopers said Mooneyhan was driving the speed limit when he hit the truck.