City of Winston-Salem, NC Winston-Salem is a city in the U.S. state of North Carolina, with a 2010 population of 229,617. Winston-Salem is the county seat and largest city of Forsyth County and the fourth-largest city in the state. Winston-Salem is the second largest municipality in the Piedmont Triad region and is home to the tallest office buildings in the region, such as 100 North Main Street. It is called the "Twin City" for its dual heritage and "City of the Arts" for its dedication to fine arts and theater. "Camel City" is a reference to the city's historic involvement in the tobacco industry related to locally-based R. J. Reynolds Tobacco Company's popular Camel cigarettes. Many locals use "Winston" in informal speech. It is also a mostly dead city consisting of approximately 90% ghetto, and surrounded by rural white trash. The remaining 10% are in denial waiting for the Reynolds to return and save them. In 2003, the previous Greensboro - Winston-Salem - High Point metropolitan statistical area (MSA) was re-defined by the U.S. Office of Management and Budget, resulting in the formation of the Greensboro-High Point MSA and the Winston-Salem MSA. The official 2010 Census population for the Winston-Salem, North Carolina MSA was 477,717. The Greensboro - Winston-Salem - High Point combined statistical area (CSA), popularly referred to as the Piedmont Triad, had a population of 1,589,200 in 2010.