BLS metro-level wage data places Marriage and Family Therapists pay in Winston-Salem, NC at a median of $50,640 per year ($24.35/hr/hour), drawn from the OEWS May 2025 release for this Metropolitan Statistical Area. Compared to the national median of $66,940, Winston-Salem pays 24% below, which typically tracks with a lower local cost of living or smaller specialized-employer cluster. Approximately 80 marriage and family therapistss are employed across the Winston-Salem MSA in SOC 21-1013.

The Winston-Salem pay distribution spans from $44,650 at the 10th percentile to $95,090 at the 90th — a 2.1× spread that reflects experience tenure, specialization, employer size, and the difference between public-sector, nonprofit, and private-sector compensation inside the metro. The 25th percentile sits at $44,770 and the 75th at $78,250, so half of Winston-Salem-based marriage and family therapistss earn within that middle band.

Metro figures capture where you actually work, not just where you live — which matters for commuters. BLS draws metro boundaries from the OMB MSA definitions, so Winston-Salem, NC covers the central city plus outlying counties tied to the metro economically. Remember that OEWS wages reflect base pay only: employer-provided health insurance, retirement matches, stock options, signing bonuses, overtime, and tips are excluded and can add 20-40% to real total compensation. Before using this metro median as a negotiation anchor, triangulate against the same occupation's national profile (linked below), its state-wide NC data, and peer-metro comparisons — a median is a starting point, not a ceiling.