- Middlesex, Tasmania is a tourist town near Cradle Mountain
- Middlesex County - the central third of the country (contains the parishes of Clarendon, Manchester, Saint Ann, Saint Catherine, Saint Mary)
- Middlesex - an historical county now mostly absorbed into Greater London; small parts were transferred to Berkshire and Surrey
- Middlesex - a borough in Middlesex County, New Jersey
- Middlesex - a town in Yates County, New York (state)
- Middlesex - a town in Nash County, North Carolina
- Middlesex - a town in Washington County, Vermont
- Middlesex Township - in Butler County, Pennsylvania
- Middlesex Township - in Cumberland County, Pennsylvania
See also: Middlesex County
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