In 1830, he ran for a seat in the North Carolina House of Representatives from Randolph County, motivated in large part by a failing law practice. His major shortcoming, he had decided, was his deficiency as a public speaker. His peers at the Bar persuaded him there was no better way to improve his oratory and achieve better rhetoric than to become a member of the North Carolina General Assembly, which thrives on "talk".
He served two terms in the House, took a break from public service to build a lucrative law practice, was elected to the North Carolina Senate, and then ran twice for Congress, both times unsuccessfully.
In 1858, Worth was again elected to the State Senate, where he was made chairman of a committee to investigate the poorly-run North Carolina Railroad. He pursued this official duty so relentlessly that the president of the Railroad, formerly a good friend, challenged Worth to a duel, which Worth declined.
Worth had the unhappy duty of issuing notes and bonds to finance the State's share of its war debt. Of the some $20 million in notes authorized by the State, Worth issued $8.5 million and $5.2 million were outstanding at the end of the war. War bonds totaling more than $13 million were issued. At the end of the war, all of the State's war debt was repudiated.
Just before Raleigh was occupied by Sherman's conquering forces at the end of the war, Governor Zebulon B. Vance charged Worth with the duty of safeguarding the State archives, which he did by evacuating them to Company Shops in Alamance County. Worth was so highly regarded that when William W. Holden was installed as the provisional Governor, he requested Worth continue as the provisional Treasurer. Worth held that title for five months until he resigned during his campaign against Gov. Holden in a special November 9, 1865 election. Worth is the only statewide North Carolina Treasurer to become Governor.
Worth was re-elected on October 18, 1866 for a term that started Dec. 22, 1866. He won 34,250 votes (75.9%) to 10,759 votes (23.8%) for former U.S. Rep. Alfred Dockery, running on the National Union Party ticket. In both his gubernatorial campaigns, Worth emphasized that he had opposed secession and that he sought to heal state and national divisions. He expressed support for President Andrew Johnson.
The major event of Worth's second term was the state constitutional convention, held in early 1868 to draft a constitution meeting the requirements of Congress. One of Worth's major interests was to restore North Carolina to the Union. Worth was disappointed with the new constitution and refused to run for re-election on the Conservative Party ticket in the election of 1868. He did not recognize the legitimacy of that election, which William W. Holden won. Nevertheless, he wrote to Holden: "I surrender the office to you under what I deem Military duress.
Worth died 14 months after leaving office as Governor. He is buried in Historic Oakwood Cemetery.