Exhibit 99.3

CONSENT OF KEEFE, BRUYETTE & WOODS, INC.

We hereby consent to the inclusion of our opinion letter to the Board of Directors of American National Bankshares Inc. (“American”) as Annex B to the Joint Proxy Statement/Prospectus which forms a part of the Registration Statement on Form S-4 dated the date hereof relating to the proposed merger of MidCarolina Financial Corporation with and into American. This consent relates solely to Amendment No. 1 of the Registration Statement and not to any subsequent amendments thereto or any other document.

In giving such consent, we do not admit that we come within the category of persons whose consent is required under Section 7 of the Securities Act of 1933, as amended or the rules and regulations of the Securities and Exchange Commission thereunder, nor do we hereby admit that we are experts with respect to any part of such Registration Statement within the meaning of the term “experts” as used in the Securities Act or the rules and regulations of the Securities and Exchange Commission thereunder.

Dated: March 29, 2011

Keefe, Bruyette & Woods Ÿ 787 Seventh Avenue Ÿ New York, NY 10019

212.887.7777 Ÿ Toll Free 800.966.1559 Ÿ www.kbw.com