Historically, the North Shore referred to the area serviced by the now defunct Chicago North Shore and Milwaukee Railroad, which ran along Lake Michigan's western shore between Chicago and Milwaukee from 1896 until 1963. Today it refers to the suburbs north of Chicago along the lakefront. Now, as then, the area includes many of the most affluent communities in the Midwest and the United States.

A few inland suburbs — e.g., Skokie, Glenview, Deerfield, Northfield, and Northbrook—also are considered by some to be part of the North Shore because of their contiguity and affluence. These suburbs are also home to various regional shopping destinations, including Westfield Old Orchard, Renaissance Place, The Glen Town Center and Northbrook Court shopping malls. However, most locals insist that the North Shore comprises only the older suburbs (fully or substantially developed before World War II and certainly prior to the 1963 demise of the North Shore rail line) directly adjacent to the lake, not the younger (mostly developed after World War II), inland suburbs. The North Shore is noteworthy for being one of the few remaining agglomerations of streetcar suburbs in the United States.

The North Shore is also the home of the Ravinia Festival, a world-class outdoor music theater. The Green Bay Trail, an award-winning pedestrian and bicycle path, begins in Wilmette and runs north just to the east of the Chicago Botanic Garden and past the front gate of Ravinia Festival park all the way up to Illinois Beach State Park in Zion, alongside Metra's Union Pacific North Line railroad tracks.

The area also lends its name to an area hospital system NorthShore University HealthSystem.