Usually considered in the 6-15 range of most prestigious universities in the country, regardless of region. Definitely seen as equivalent to mid-level Ivy League school on the East Coast (e.g. Penn, Brown, Dartmouth) and usually viewed as the best school located in the South by those living in the South (with maybe Vanderbilt being it’s only competition, and some in state in North Carolina try to convince themselves that UNC is better…). Note that “prestige” by the common public, corporations, and academics can and often do differ. The second two are the ones that should matter to people in reality. Leaders of the largest companies in the world placed Duke as #10 in reputation in the nation according to a poll published by the NY Times: http://www.nytimes.com/imagepages/2011/10/20/education/20iht-SReducEmploy20-graphic.html