Johnston Health is Johnston County's health care system. Established in 1951, the flagship hospital in Smithfield is licensed for 179 medical/surgical beds and 20 behavioral health beds. It includes a 24/7 emergency department and various outpatient services. It also shares a campus with the SECU Hospice House and the Johnston Medical Mall, which is anchored by HealthQuest Fitness and Wellness Center. In February of 2010, the hospital opened a five-story wing with 101 patient suites, a food court, modern operating rooms and 16-bed intensive care unit. The original 1950s building now houses patient services such as sleep studies and joint replacement surgery rehab. It's also used as office space for administrators and departments such as marketing, human resources and medical staff services.

In 2009, Johnston Health Clayton was opened to provide easy access to care for the growing population in and around Clayton. With this growth came the expansion of the Clayton campus to a three-story wing in 2015. Along with a freestanding emergency department and outpatient services including surgery, imaging and a lab, Johnston Health Clayton offers 50 inpatient beds to care for the sick and injured with expanded services such as labor and delivery. The three-story Johnston Professional Plaza is home to Johnston Health's medical and radiation oncology services as well as a primary care practice.