On March 17, 2013, Larrañaga coached the Hurricanes to the ACC tournament title—the first tournament title in the program's history — with an 87-77 win over North Carolina. On April 4, 2013, Larrañaga was voted the Associated Press' college basketball coach of the year. A week later, the Hurricanes advanced to the Sweet 16 of the NCAA Tournament with their school-record 29th win. The season ended the following weekend with a loss to Marquette. He claimed the Hurricanes had not enough energy to win the game because of Reggie Johnson's injury and Shane Larkin's sickness.