| Year | Won | Margin | Democratic | Republican | Total |
|---|---|---|---|---|---|
| 2024 | R | 7,374 | 9,659 | 17,176 | |
| 2020 | R | 7,578 | 9,172 | 16,962 | |
| 2016 | R | 6,740 | 8,583 | 15,818 | |
| 2012 | R | 7,655 | 8,213 | 16,051 | |
| 2008 | R | 7,607 | 7,833 | 15,623 | |
| 2004 | R | 5,518 | 7,726 | 13,356 | |
| 2000 | R | 5,092 | 6,352 | 11,925 | |
| 1996 | D | 5,220 | 5,013 | 11,654 | |
| 1992 | R | 4,950 | 5,666 | 13,125 | |
| 1988 | R | 4,443 | 6,926 | 11,542 | |
| 1984 | R | 4,355 | 8,047 | 12,466 | |
| 1980 | R | 4,872 | 5,371 | 10,698 | |
| 1976 | D | 4,807 | 4,494 | 9,536 | |
| 1972 | R | 2,406 | 6,496 | 9,026 | |
| 1968 | R | 2,467 | 3,231 | 9,181 | |
| 1964 | D | 3,528 | 3,145 | 6,683 | |
| 1960 | D | 2,884 | 2,676 | 5,581 | |
| 1956 | R | 2,213 | 2,823 | 5,204 | |
| 1952 | R | 2,220 | 2,626 | 4,864 | |
| 1948 | D | 1,669 | 1,088 | 3,104 | |
| 1944 | D | 1,747 | 1,045 | 2,795 | |
| 1940 | D | 1,476 | 882 | 2,366 | |
| 1936 | D | 1,583 | 670 | 2,259 | |
| 1932 | D | 2,458 | 527 | 3,007 | |
| 1928 | D | 1,826 | 1,367 | 3,193 | |
| 1924 | D | 2,087 | 307 | 2,429 | |
| 1920 | D | 2,026 | 409 | 2,480 | |
| 1916 | D | 1,745 | 299 | 2,070 | |
| 1912 | D | 1,825 | 153 | 2,114 | |
| 1908 | D | 1,748 | 337 | 2,141 | |
| 1904 | D | 1,517 | 256 | 1,835 | |
| 1900 | D | 3,210 | 1,460 | 4,740 | |
| 1896 | D | 3,115 | 1,675 | 5,004 | |
| 1892 | D | 3,529 | 1,733 | 5,448 | |
| 1888 | — | — | — | — | |
| 1884 | — | — | — | — | |
| 1880 | — | — | — | — | |
| 1876 | — | — | — | — |
Accomack sits on Virginia's isolated Eastern Shore peninsula, separated from the mainland by the Chesapeake Bay. Its economy anchors on agriculture and seafood, and its relatively large rural Black population makes it one of the more demographically complex counties in the region.
The county's recent history is a story of close margins. The Democratic margin reached seventy-nine points in 1912; the Republican margin reached forty-five points in 1972. Most other elections have been decided by single-digit points.
Accomack County's demographics — a population of 33,335, a 59% non-Hispanic-white share, a median household income of $58,993 — situate the county close to national averages on several dimensions. The county's voting pattern over the last decade is most similar to that of Polk County and Lee County.