The Mount Jefferson Presbyterian Church came into being on Sunday, August 27, 1961, when the Winston-Salem Presbytery, present in its commission, merged three of Ashe County's Presbyterian churches. They were Jefferson Presbyterian Church, Obids Presbyterian Church, and West Jefferson Presbyterian Church.

The final entry in the minutes of each of these churches, together with the record of the organizational meeting, were given as the first record of the new church.

Rev. Thomas I. Smith was installed by Rev. John R. Smith as its first pastor. Rev. Smith served as pastor from 1961 to 1975, followed by Rev. John E. Gass (1975-1977), Rev. Wayne Dixon (1977), Rev. A.V. Ray (1978-1983), Rev. Gaston Boyle, Jr. (1983), Rev. Kermit W. Dancy (1983-2004), Rev. O. Leighton Culler (interim 2004-2005), and Rev. William Blount (Billy) Robinson (2005 -2010), Rev. Thom Burleson (interim 2010-2012) and Rev. Will Heyward, 2012 to the present.