Ramone Alston, 30, escaped from North Carolina Department of Corrections custody while receiving medical care at UNC Hospital in Hillsborough, according to the Orange County Sheriff's Office.
The sheriff's office said Alston managed to free himself from leg restraints while inside a North Carolina Department of Adult Correction (DAC) van in the parking lot of the clinic.
"As they (the officers) pulled up to the back entrance of the hospital and as they were removing Mr. Alston from the vehicle, he broke away from the officers in the parking lot and ran to the woods," DAC Communications Director Keith Acree said.
Two officers were in charge of getting Alston out of the vehicle and into the hospital for treatment.
Alston was wearing a gray T-shirt, brown pants and New Balance tennis shoes when he ran from the van. He was last seen with his hands still cuffed in front of him.
"Just at this point, until we learn otherwise, the most distinguishing feature is someone running with a belly chain and handcuffs with a black box," Orange County Sheriff's Office Communications Manager Alecia Stemper said. "If you see him, call 911 immediately. Do not approach."
Alston reportedly has friends and family living in the area. However, it remains unclear if this was a planned escape attempt.
Alston was convicted of shooting and killing a 1-year-old girl in 2015.
Officials are asking the public to immediately call 911 if they see Alston and warning them not to approach him.
ABC News contributed to this report.