North Carolina has already secured at worst a share of the regular season title. A win Saturday gives them the outright title, but a loss means the two rivals would be tied in the conference and have split their head-to-head matchups.
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This game will be the first since 2012 when the two met at the end of the year with at least a share of the ACC regular season title on the line.
UNC basketball coaches and players talk about preps for Duke game
It's also the 50th such meeting with both teams ranked in the top 10. The 49th meeting happened earlier this year, which the Tar Heels won 93-84. The next most matchups of top 10 teams in college basketball history is UNC and NCSU, which has happened just 14 times.
Saturday's game will tip off at 6:30 p.m. at Cameron Indoor Stadium. ESPN's College Gameday will broadcast from the arena for the 13th time. That's more than any other venue, passing the Dean E. Smith Center (12) and Rupp Arena (12).
Who gets the No. 1 seed in the ACC Tournament?
If Duke wins and the two rivals are tied atop the conference, seeding will come down to tie breakers.
The first tie breaker is head-to-head record. But in this scenario, the teams will have split their regular season matchups.
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So the next tie breaker is best record against the next highest finisher in the conference.
The scenarios surrounding that still depend on how the final games of the season go.
Virginia (12-7) is currently the third ranked team in the ACC. Carolina and Duke are both 1-0 against the Cavaliers this year.
The teams still within striking distance of affecting UNC and Duke's seeds are Clemson (11-8), Pittsburgh (11-8), Syracuse(11-9) and Wake Forest (10-9).
Duke has loses against Wake Forest and Pittsburgh. While UNC has loses against Clemson and Syracuse.
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On Saturday, Clemson plays Wake Forest, NC State plays Pittsburg, and Virginia plays Georgia Tech.
ACC Men's Basketball Tournament
This year's tournament will begin March 12 in Washington D.C.
The games are scheduled to take place Tuesday - Saturday at Capital One Arena.
The top four seeds (which will include both UNC and Duke) will not play their first games until Thursday. That means teams ranked outside the top four must play extra games if they hope to take home the tournament title and with it an automatic bid into the NCAA Men's Basketball Tournament.