Middlesex County Courthouse may refer to:

• Middlesex County Courthouse (Massachusetts), Cambridge, Massachusetts
• Eastern Middlesex County Second District Court, Waltham, Massachusetts, listed on the National Register of Historic Places (NRHP)
• Middlesex County Courthouse (Saluda, Virginia), NRHP-listed
• Middlesex County Courthouse (Urbanna, Virginia), NRHP-listed
• Middlesex County Court House (London, Ontario), Canada

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