NC Hwy 45 Bridge Boat Ramp provides access to the lower Roanoke River and serves as a take-out point for paddlers completing multi-day trips down the Cashie River, with the ramp located near the confluence where the Cashie meets the Roanoke River braided channels.

This access point is particularly useful for canoe and kayak paddlers finishing longer paddle trail routes, including the popular "Cruise the Cashie" trip from Windsor.

The ramp accommodates various watercraft and is maintained by the NC Wildlife Resources Commission as part of the Roanoke River Paddle Trail system.