Kennedy Meeks added 15 points and 10 rebounds for the Tar Heels (13-4, 3-1 Atlantic Coast Conference). They led by 12 in the second half and by double figures near the 4-minute mark before watching N.C. State (12-6, 3-2) twice claw within a point in the final seconds.
Nate Britt made two free throws with 3.1 seconds left to keep UNC up three, then Paige hit two more with 1 second to go for an 81-78 lead.
N.C. State got one more chance, with Abdul-Malik Abu being fouled on a long inbounds pass with two-tenths of a second left. Abu made the first free throw and intentionally missed the second, but fellow freshman Cody Martin's tip attempt in traffic didn't drop as the horn sounded.
Ralston Turner scored 20 points to lead N.C. State, including a couple of big 3-pointers late in the Wolfpack's comeback. Leading scorer Trevor Lacey finished with 19 points but shot just 4-for-13 while facing constant defensive attention from UNC's J.P. Tokoto.
UNC shot 56 percent for the game, but cooled late and had to hold on despite going the final 4:38 without a basket.
It was the Tar Heels' 17th win in 18 meetings in the long rivalry, allowing coach Roy Williams to improve to 23-2 against N.C. State as the UNC coach.
The game was a rematch of an overtime classic from last February, won when Paige hit a running layup with 0.9 seconds left in overtime to cap a 35-point night in UNC's 85-84 win.
Paige, who is battling a foot injury, went 6-for-9 from the field in this one and hit all five of his 3-point tries - including UNC's last basket.
N.C. State came in after a weekend upset of unbeaten Duke, but couldn't follow that with a win against another ranked rival from just down the road.
UNC: UNC shot 14-for-24 in the opening half, with the 58-percent mark standing as its best in a half in an ACC game this season. ... UNC was without freshman point guard Joel Berry II, who will be sidelined for a few weeks with a groin injury. They were also without reserve guards Stilman White and Luke Davis due to foot injuries.
N.C. State: This was N.C. State's third straight game against a ranked opponent. The Wolfpack lost at then-No. 3 Virginia last week before beating Duke. ... Kyle Washington matched his career high with 17 points. ... N.C. State shot 52 percent after halftime after trailing 32-26 at the break.
UNC hosts Virginia Tech on Sunday.