For freshmen and sophomores, Greek life dominates the nightlife, but once students turn 21, the options expand. Winston-Salem has made great strides in the past few years and has a decent downtown scene. Wake Forest has certainly helped by instituting downtown shuttles that go from campus to popular downtown bars. Aside from the bar and frat scene, there are some great art galleries and coffee shops to visit also. If you include all of the different activities and events on campus (as well as studying), you will be hard-pressed to be bored.
Probably the biggest complaint among students is that downtown Winston-Salem is not within walking distance. In fact, there is very little to walk to once you leave Wake's campus. Shuttles and the opening of Shorty's on campus has helped to improve the nightlife even with the absence of a true college town atmosphere like Chapel Hill or Charlottesville.