| Year | Won | Margin | Democratic | Republican | Total |
|---|---|---|---|---|---|
| 2024 | R | 1,886 | 7,746 | 9,719 | |
| 2020 | R | 1,954 | 7,485 | 9,534 | |
| 2016 | R | 1,768 | 6,454 | 8,525 | |
| 2012 | R | 2,417 | 5,622 | 8,259 | |
| 2008 | R | 2,879 | 5,491 | 8,531 | |
| 2004 | R | 2,572 | 5,507 | 8,215 | |
| 2000 | R | 2,254 | 4,901 | 7,385 | |
| 1996 | R | 2,301 | 3,547 | 6,771 | |
| 1992 | R | 2,465 | 3,521 | 7,189 | |
| 1988 | R | 2,093 | 3,990 | 6,229 | |
| 1984 | R | 1,908 | 4,703 | 6,674 | |
| 1980 | R | 2,382 | 3,436 | 6,123 | |
| 1976 | D | 2,740 | 2,349 | 5,377 | |
| 1972 | R | 1,032 | 2,758 | 3,869 | |
| 1968 | R | 1,105 | 2,187 | 5,275 | |
| 1964 | R | 1,508 | 1,595 | 3,107 | |
| 1960 | D | 1,655 | 1,362 | 3,028 | |
| 1956 | D | 1,677 | 1,345 | 3,062 | |
| 1952 | D | 1,554 | 1,314 | 2,872 | |
| 1948 | D | 760 | 648 | 1,840 | |
| 1944 | D | 1,383 | 706 | 2,096 | |
| 1940 | D | 1,479 | 514 | 1,999 | |
| 1936 | D | 1,588 | 726 | 2,320 | |
| 1932 | D | 1,342 | 486 | 1,853 | |
| 1928 | R | 883 | 1,191 | 2,074 | |
| 1924 | D | 1,138 | 783 | 1,932 | |
| 1920 | R | 1,154 | 1,230 | 2,387 | |
| 1916 | D | 872 | 815 | 1,690 | |
| 1912 | D | 698 | 434 | 1,490 | |
| 1908 | R | 723 | 1,092 | 1,818 | |
| 1904 | D | 737 | 616 | 1,383 | |
| 1900 | R | 1,026 | 1,281 | 2,315 | |
| 1896 | R | 886 | 1,140 | 2,039 | |
| 1892 | D | 1,288 | 873 | 2,234 | |
| 1888 | — | — | — | — | |
| 1884 | — | — | — | — | |
| 1880 | — | — | — | — | |
| 1876 | — | — | — | — |
Tucked into the Blue Ridge foothills along the North Carolina border, Patrick County delivered a roughly 60-point Republican presidential margin in 2024, reflecting a rural Southside Virginia electorate that has shifted sharply rightward over the past two decades.
The Democratic margin in Patrick County peaked at forty-eight points in 1940. By 1980 the county had flipped, voting Republican for the first time in many years. The 2024 margin was sixty points, the most Republican-leaning result in the county's modern history.
The economic context is the key. Patrick County's median household income of $53,038 sits well below state and national norms, and 12% of residents live below the federal poverty line. The shift here is part of a broader realignment of working-class places across the country. The county's voting pattern over the last decade is most similar to that of Franklin County and Huntingdon County.