Judge Cynthia Graham Howe was born on May 3, 1952, in Burlington, North Carolina, to the late William Fleming and Robbie Leonard Graham. She was reared in Burlington with her only brother, William L. Graham, and graduated from Walter M. Williams High School.

She spent her first year of college at the University of North Carolina in Chapel Hill and then transferred to Western Carolina University in Cullowhee, North Carolina, where she graduated summa cum laude with a Bachelor of Science in Education degree. Judge Howe spent two years in the National Teacher Corps program and received her Master of Arts in Education degree, also from Western Carolina University. In 1976, Judge Howe moved to South Carolina and taught Reading and Language Arts at Loris High School. She obtained her J.D. degree in 1981 from the University of South Carolina Law School.

Immediately after law school, from 1981 through 1983, Judge Howe clerked for the Honorable David Walker Harwell, then associate justice for the South Carolina Supreme Court. She then entered private practice in Myrtle Beach with Van Osdell, Lester, Stewart & McCutchen, concentrating in the areas of civil litigation and appeals. She subsequently became a partner in the firm, which ultimately became Van Osdell, Lester & Howe, P.A. In 2006, she moved her practice to Conway and thereafter became a partner in Battle, Vaught & Howe,
P.A. Judge Howe was appointed as the Horry County Master in Equity in March 2009, replacing J. Stanton Cross, Jr., who retired.