Five Wolfpack players finished in double-figures. It took a team effort as top scorer D.J. Horne (16.8 ppg) did not play because of a hip injury.
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Casey Morsell scored 25 points, and Jayden Taylor had 18 points, eight rebounds and four steals as the Wolfpack survived a 36-point performance by Skyy Clark.
It was a homecoming of sorts for Morsell, who hails from Fort Washington, Maryland.
"It was an amazing experience," Morsell said. "I had a lot of friends come to watch me play. I'd never played on this court but ... I've watched guys like Gilbert Arenas ... so just to have the opportunity to play on this court in front of family, it means the world."
Clark made a 3-pointer on back-to-back possessions to tie it at 75-all with 4:50 to go and set a career-high in scoring with 30. But Taylor answered with two straight makes from distance to give N.C. State an 81-77 lead.
N.C. State made 11 free throws in the final three minutes to seal it. The Wolfpack finished 33 of 40 from the stripe, with 13 straight makes by Morsell. Louisville was 11 of 11.
Michael O'Connell added 16 points, DJ Burns Jr. scored 12 and Ben Middlebrooks had 11 for N.C. State.
Clark finished 12-of-17 shooting, including 7 of 9 from 3-point range, for Louisville (8-24), which ended the season on an eight-game losing streak with coach Kenny Payne's future in question. Brandon Huntley-Hatfield had 17 points and seven rebounds, and Tre White added 13 points.
Louisville led 46-45 at halftime and led by as many as 12 points in the first half before having its lead trimmed to one at the break after turning it over nine times. The Cardinals shot 66.7% in the first half, including 6 of 9 from 3-point range.
Louisville's first points from a reserve came on Curtis Williams' jumper from the free-throw line with 12:46 remaining in the second half to get within 61-54. Williams finished the five points - the only bench points for the Cardinals.
The Wolfpack (18-14) will still need to win four more games to claim their first ACC championship since 1987.
NC State advances to play Syracuse (20-11) on Wednesday at 7 p.m. on ESPN2. The Wolfpack lost both regular-season meetings with the Orange, 77-65 on the road and 87-83 at home.
"We're going to have to be more balanced, more versatile, but for us, I think I think at the end of the day, it's our defense," Morsell said. "That's really what's got to improve ... it's going to get tougher as the tournament goes on and just locking in on the defensive end, the offense will take care of itself."
Clark, who entered with just 18 total points in his last three games, set a program record for single-game points in the ACC Tournament. His previous single-game high overall was 29 in a double-overtime victory over New Mexico State on Nov. 26.
NOTRE DAME 84, GEORGIA TECH 80
Freshmen Braeden Shrewsberry and Markus Burton combined for 44 points and 12th-seeded Notre Dame opened the ACC Tournament with its third straight nail-biting win over 13th-seeded Georgia Tech on Tuesday.
Shrewsberry had 23 points with five 3-pointers and Burton added 21 with eight assists as the Fighting Irish (13-19) advanced to face fifth-seeded Wake Forest despite blowing a 17-point lead in the final 13 minutes.
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Tae Davis added 12 points and Kebba Njie had 11 with nine rebounds for Notre Dame, which beat the Yellow Jackets 58-55 at home and 75-68 in overtime on the road.
The Irish were down one when Burton blew past a defender for a fast-break layup and an 81-80 lead with 1:16 to play.
Georgia Tech turned the ball over but then forced Burton into a miss on a tough layup with 26 seconds to play. However, Njie snared an offensive rebound, which led to free throws for Davis with 24.9 seconds to go. Davis made both free throws but the second was waved off by a line violation, giving the Yellow Jackets a chance, down 82-80.
Davis got his hand on a pass, forcing a turnover and Shrewsberry iced the win with two free throws with five seconds left.
Naithan George had five 3s and scored 24 points with seven assists for Georgia Tech (14-18). Baye Ndongo had 22 points and seven rebounds. Kyle Sturdivant added 10 points.
Notre Dame was 12 of 23 from 3-point range and shot 54% overall (28 of 52). Georgia Tech had eight 3s on 27 attempts and was 47% overall (27 of 57).
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Notre Dame led by 10 at halftime and quickly got it to 14 following a dunk by Carey Booth and a 3-pointer from Matt Zona made it 65-48 with 12:59 to go. Njie had the Irish on top 70-59 midway through the second half.
Georgia Tech reeled off eight straight points, with George converting a four-point play to cut the deficit to 70-67. Dallan Coleman hit a 3-pointer and George scored consecutive jumpers and the Yellow Jackets led 78-77, their first lead of the game.
Burton had 15 at halftime on 6-of-9 shooting with three 3's to help the Irish, who shot 62%, take a 45-35 lead.
Burton had a 3, followed by two jumpers before Shrewsberry's 3 made it 17-5. George had a layup and a 3 to get the Yellow Jackets back within 24-18 midway through. The lead reached 14 before six free throws in the final 1 1/2 minutes helped cut it back to 10.
BOSTON COLLEGE 81, MIAMI 65
Quinten Post scored 30 points and Jaeden Zackery scored 16 points and 11th-seeded Boston College controlled No. 14 Miami most of the way, beating the Hurricanes 81-65 in an opening-round game Tuesday night.
Boston College (18-14) plays sixth-seeded Clemson on Thursday night. That game is on ESPNU. The Eagles have a three-game winning streak, two of which are against the Hurricanes and the other against Louisville. Louisville and Miami finished last and next-to-last respectively in the ACC.
Miami (15-17) ended an injury-riddled year losing 10 straight.
In finishing a point shy of tying his career-high point total, Post recorded a double-double as he grabbed 13 rebounds. He scored 31 against Fairfield in Boston College's 89-70 season-opening win on Nov. 6.
Claudell Harris Jr. scored 12 points and Devin McGlockton 10 for the Eagles (18-14) who shot 49.2% (31 for 63).
Norchad Omier and Nijel Pack each scored 18 points and Matthew Cleveland 12 for Miami.
Post went on his own 11-0 run turning a 7-all tie into an 18-13 lead. Post made consecutive 3s around one from Miami's Wooga Poplar, had a three-point play and a jump shot in a 2 1/2 minute stretch. Boston College continued piling points and went on a 12-1 run that made for a 30-14 lead when Donald Hand Jr. made a 3 with 10:43 before halftime.
Bensley Joseph made a basket for the Hurricanes to get them within 34-26 before Boston College countered with a 13-6 outburst to close the half up 47-32.
Michael Nwoko's layup for Miami made it 64-56 with 8:04 left marking the only time the Hurricanes got within single digits after halftime, McGlockton converted a tip-in, Post added another 3 and Hand made a jumper and the Eagles' lead was 71-58 with 6:19 left.
Boston College moved its all-time series lead to 30-29 against Miami.
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The Associated Press contributed.