Arrington spent her campaign calling Sanford a "Never Trumper". But he failed to win the 50 percent necessary to avoid a runoff.
Sanford, an outspoken Trump critic, is facing a tight race against State Rep. Katie Arrington, a relative newcomer to politics.
"Mark Sanford has been very unhelpful to me in my campaign to MAGA", Trump tweeted. The onetime insurgent has made allegiance to his leadership a litmus test in many Republican races. But during the campaign, he ran ads saying how often he voted with the president.
Sanford made enemies as governor in 2009, when he disappeared to Argentina during an extramarital affair. Sanford's original scandal revolved around the fact that he was cheating on his wife with an Argentinian journalist, lying to the public about it and was later caught trespassing at his former home in violation of their separation agreement.
In an interview with Politico last weekend, Sanford suggested that a loss in his re-election bid could cause other Republicans to think twice before speaking out against the Trump administration.
Some Republicans rushed to Sanford's defence after Trump's bruising intervention.
"Unlike you, Mark has shown humility in his role and a desire to be a better man than he was the day before", Amash said on Twitter. Horsford held the Democratic-leaning seat for one term before losing in 2014 to Republican Cresent Hardy, who is running again this year and leading a six-way GOP race for the seat. The Congressman's prediction came true, with him conceding to Arrington. He's one of the most principled, consistent, and conservative members of Congress I've ever known.
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CNN has also projected the primary winners in three House races where Democrats are hoping to unseat Republicans in the fall.
Democrats have a credible, well-funded candidate seeking this seat - Charleston, S.C. environmental attorney Joe Cunningham.
Over more than two decades, SC voters forgave U.S. Rep. Mark Sanford for his quirkiness, his infidelity and his lies.
As expected, North Dakota Republicans chose Rep. Kevin Cramer to challenge Democratic Sen.
Heller's state is Democrat-leaning and was narrowly won by Clinton in 2016, while Heitkamp's is dominated by Republicans and voted overwhelmingly for Trump.
In Nevada, Democrats tapped Rep. Jacky Rosen to take on Republican Sen. He somewhat improbably won election to Congress a few years later. But if not, the lowest vote-getter is eliminated, with their votes reallocated until one contender gains a majority. Pete Domenici and Michelle Laxalt, the daughter of former Nevada governor and senator Paul Laxalt.
There were exceptions in Cherokee and Darlington counties, where sharply contested local races had somewhat heavier turnout, Chris Whitmire with the election commission said.