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