Uruguay reached the semi-finals of the World Cup for the first time since 1970, after eliminating Ghana on a penalty shoot-out.
Sulley Muntari struck a long-range opener for Ghana on the stroke of half-time, while the impressive Diego Forlan equalised for Uruguay with a free-kick 10 minutes after the restart.
Extra-time seemed destined to remain scoreless until Luis Suarez deliberately handled a shot on the goal line in the dying seconds of extra-time.
However, striker Asamoah Gyan, who had already converted two penalties in South Africa, missed the penalty, hitting the top of the crossbar with the last kick of the game to send the match to a penalty shootout..
Gyan stepped up to take the first spot-kick of the shoot-out and scored, but team mates John Mensah and Dominic Adiyiah both had their efforts saved by Fernando Muslera.
Sebsatian Abreu then showed iced-cold composure to dink the decisive penalty beyond Richard Kingson as Uruguay sealed a semi-final tie against the Netherlands.