The powerful storm inundated coastal streets with ocean water and left tens of thousands without power. Forecasters said "catastrophic" freshwater flooding was expected along waterways far from the coast of the Carolinas.
ABC News has confirmed that Pender County Emergency Management in North Carolina is reporting one storm-related death.
Director Tom Collins says the woman in Hampstead had a heart attack Friday morning, but emergency crews could not get to her because of downed trees in the road. Collins says they have a front loader they're using to clear the roads, but a tree went through the windshield of it.
NEW: #Hurricane #Florence has made landfall near Wrightsville Beach, North Carolina at 7:15 AM EDT (1115 UTC) with estimated maximum winds of 90 mph (150 km/h), and a minimum central pressure estimate of 958 mb (28.29"). https://t.co/tW4KeGdBFb pic.twitter.com/vzpe6MjTf9— National Hurricane Center (@NHC_Atlantic) September 14, 2018
More than 60 people had to be pulled from a collapsing motel at the height of the storm, and many more who defied evacuation orders were hoping to be rescued. Pieces of buildings ripped apart by the storm flew through the air.
Most ominously, forecasters said the terrifying onslaught would last for hours and hours, because Florence was barely creeping along and still drawing energy from the ocean.
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Florence made landfall as a Category 1 hurricane a few miles east of Wilmington, as the center of its eye moved onshore near Wrightsville Beach, the National Hurricane Center said.
Coastal streets flowed with frothy ocean water and tens of thousands lost electricity. Forecasters said "catastrophic" freshwater flooding was expected along waterways far from the coast of the Carolinas.
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Winds bent trees toward the ground and raindrops flew sideways as Florence moved in for an extended stay, with enough of its killer winds swirling overseas to maintain its power. Forecasters said the onslaught could last for days, leaving a wide area under water from both heavy downpours and rising seas.
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The wind howled and sheets of rain splattered against windows of a hotel before dawn in Wilmington, where Sandie Orsa of Wilmington sat in a lobby lit by emergency lights after the power failed.
"(It's) very eerie, the wind howling, the rain blowing sideways, debris flying," said Orsa, who lives nearby and fears splintering trees will pummel her house.
A weather station at a community college recorded a 100 mph wind gust, and forecasters tweeted that a 91 mph wind gust slammed into Wilmington's airport, surpassing the power of Hurricane Fran two decades ago.
The National Hurricane Center said a gauge in Emerald Isle, North Carolina, reported 6.3 feet (1.92 meters) of inundation. Emerald Isle is about 84 miles 135 kilometers) north of Wilmington.
And about 46 miles farther up the waterfront, in New Bern, about 150 people were waiting to be rescued from floods on the Neuse River, WXII-TV reported. The city said two FEMA teams were working on swift-water rescues and more were on the way.
The worst of the storm's fury had yet to reach coastal South Carolina, where emergency managers said people could still leave flood-prone areas.
"There is still time, but not a lot of time," said Derrec Becker of the South Carolina Department of Emergency Management.
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More than 80,000 people in North Carolina already were without power as the storm began buffeting the coast, and more than 12,000 were in shelters. Another 400 people were in shelters in Virginia, where forecasts were less dire.
North Carolina corrections officials said more than 3,000 people were relocated from adult prisons and juvenile centers in the path of Florence, and more than 300 county prisoners were transferred to state facilities.
Officials said some 1.7 million people in the Carolinas and Virginia were warned to evacuate, but it's unclear how many did. The homes of about 10 million were under watches or warnings for the hurricane or tropical storm conditions.
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Spanish moss waved in the trees as the winds picked up in Wilmington, and floating docks bounced atop swells at Morehead City. Ocean water flowed between homes and on to streets on the Outer Banks; waves crashed against wooden fishing piers.
Coastal towns in the Carolinas were largely empty, and schools and businesses closed as far south as Georgia.
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Forecasters said conditions will continue to deteriorate as the storm makes its way slowly inland. Its surge could cover all but a sliver of the Carolina coast under as much as 11 feet (3.4 meters) of ocean water, and days of downpours could unload more than 3 feet (0.9 meters) of rain, touching off severe flooding.
Once a Category 4 hurricane with winds of 140 mph (225 kph), the hurricane was downgraded to a Category 1 on Thursday night.
Forecasters said that given the storm's size and sluggish track, it could cause epic damage akin to what the Houston area saw during Hurricane Harvey just over a year ago, with floodwaters swamping homes and businesses and washing over industrial waste sites and hog-manure ponds.
The hurricane was seen as a major test for the Federal Emergency Management Agency, which was heavily criticized as slow and unprepared for Hurricane Maria in Puerto Rico last year.
Not everyone was taking Florence too seriously: About two dozen locals gathered Thursday night behind the boarded-up windows of The Barbary Coast bar as Florence blew into Wilmington.
Others were at home hoping for the best.
"This is our only home. We have two boats and all our worldly possessions," said Susan Patchkofsky, who refused her family's pleas to evacuate and stayed at Emerald Isle with her husband. "We have a safe basement and generator that comes on automatically. We chose to hunker down."