Authorities said the bus stopped along North Hills Drive to let 6-year-old Ashley Ramos-Hernandez off. While she crossed the street, she was struck.
Neighbors said they heard the impact and rushed outside.
"There was this little girl, 6-year-old, laying there in a pool of blood with her eyes half open," neighbor Beverly Deheney said. "People started coming from everywhere and we started crying. It was very sad."
Ramos-Hernandez was taken to WakeMed where she later died. She attended Green Elementary off Six Forks Road.
The driver of the car, 83-year-old Geraldine Baron Deitz, told police the bus driver didn't activate all the stopped signs and signals, but witnesses driving along the road told police that wasn't the case.
Deitz has been charged with misdemeanor death by vehicle and passing a stopped school bus.
She was too shaken to talk, but her husband said she takes the blame.
Meanwhile, neighbors who didn't know the little girl laid flowers and a teddy bear in her memory at the scene.
"It's just sad," neighbor Ronna Bowle said. "Second day of school, could have been our kids."
School district officials say grief counselors would be on campus Thursday to help other students deal with the tragedy.