Worth was nominated by the Conservative Party, a state coalition that included most Democrats and some former Whigs, to run for governor in North Carolina's first and only special election for the office. Worth had been associated with the Conservative Party since the beginning of the Civil War. His opponent was the incumbent Gov. William W. Holden, who had been appointed by President Andrew Johnson and was running on the National Union Party ticket. Worth's strength was in the eastern part of the state, and Holden carried the western counties which had mostly opposed secession and the Civil War. Worth won with 32,549 votes (55.5%) to Holden's 25,809 votes (44.0%). Worth won with the support of many elements of the state that had supported secession. The 1865 election had been conducted according to the 1865 state constitution, which was rejected by the U.S. Congress.