Defender Mathias Olivera scored to give Uruguay the win that sees them advance to the quarter-finals as group winners, with the South Americans winning three of their first-round matches for the first time since 1959.
Panama’s 3-1 win over Bolivia saw them finish second on six points, three ahead of the United States.
“The pitch was very hard to play on,” Uruguay midfielder Manuel Ugarte said.
“But hey, when we have to score, we score; when we have to play, we play. It’s a bit of adapting to the matches and the moments of each match.”
The defeat has ramped up the pressure on U.S. coach Gregg Berhalter, with fans chanting: “Fire Gregg” in the second half and after the final whistle.
“We know that we’re capable of more, and this tournament, we didn’t show it,” Berhalter told reporters.
“It’s really as simple as that. I think that, you know, you look at the stage that was set with the fans in this tournament, with the high level of competition in this tournament, and we should have done better.”
Needing a win to give themselves the best chance of progressing, the U.S. started well but Uruguay grew into the game as the first half wore on.
The match was punctuated by a series of stoppages and physical altercations, with the referee struggling to maintain control at times and making some questionable decisions when it came to playing advantage.
Uruguay lost Maximiliano Araujo in the 27th minute after a coming-together with U.S. defender Tim Ream. The forward had a neck brace fitted before being carried off on a stretcher and replaced by Cristian Olivera.
U.S. striker Folarin Balogun also had to be substituted after appearing to pick up an injury in a nasty collision with Uruguay goalkeeper Sergio Rochet.
Despite the hosts’ early attacking intensity, Uruguay produced the better chances in the first half, nearly taking the lead in the 38th minute when Olivera whipped a dangerous cross into the box but Darwin Nunez shot just wide.
The biggest cheer of the night from the crowd at Arrowhead Stadium came in the second half when Bolivia scored an equaliser against Panama in the other Group C match, briefly moving the U.S. up to second place, but their joy was short-lived.
Uruguay took the lead in the 66th minute as Olivera bundled in a rebound after U.S. goalkeeper Matthew Turner could only parry Ronald Araujo’s header back into the box. The goal was given after a lengthy VAR review for offside.
The U.S. had an excellent opportunity to equalise in the 75th minute when Rochet spilled the ball and found himself stranded several metres from the goal but Christian Pulisic’s deflected shot was kept out by a goal-line clearance from Ugarte.
The U.S. continued to battle deep into stoppage time but Uruguay’s backline proved up to the challenge and held out to clinch their first win against the U.S. since the 1993 edition of the Copa America.
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