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In the fourth round of the CONCACAF 2006 World Cup qualification, the six remaining teams from the third round were put in a single group, and played against each other home-and-away. The three teams with most points qualified for the 2006 FIFA World Cup. The fourth-placed team, Trinidad and Tobago, advanced to the AFC-CONCACAF playoff against the winner of the fourth round of Asia, Bahrain.
| Pos | Team | Pld | W | D | L | GF | GA | GD | Pts | Qualification |  |
 |
 |
 |
 |
 | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | United States |
10 | 7 | 1 | 2 | 16 | 6 | +10 | 22[lower-alpha 1] | 2006 FIFA World Cup | — | 2–0 | 3–0 | 1–0 | 2–0 | 2–0 | |
| 2 | Mexico |
10 | 7 | 1 | 2 | 22 | 9 | +13 | 22[lower-alpha 1] | 2–1 | — | 2–0 | 2–0 | 5–2 | 5–0 | ||
| 3 | Costa Rica |
10 | 5 | 1 | 4 | 15 | 14 | +1 | 16 | 3–0 | 1–2 | — | 2–0 | 3–2 | 2–1 | ||
| 4 | Trinidad and Tobago |
10 | 4 | 1 | 5 | 10 | 15 | −5 | 13 | Inter-confederation play-offs | 1–2 | 2–1 | 0–0 | — | 3–2 | 2–0 | |
| 5 | Guatemala |
10 | 3 | 2 | 5 | 16 | 18 | −2 | 11 | 0–0 | 0–2 | 3–1 | 5–1 | — | 2–1 | ||
| 6 | Panama |
10 | 0 | 2 | 8 | 4 | 21 | −17 | 2 | 0–3 | 1–1 | 1–3 | 0–1 | 0–0 | — |
Source: [1]
Notes:
Notes:
| Costa Rica | 1–2 | Mexico |
|---|---|---|
Wanchope  38' |
Report | Lozano 8', 10' |
| Trinidad and Tobago | 1–2 | United States |
|---|---|---|
| Eve 89' |
Report | Johnson 30' Lewis 54' |
Attendance: 11,000
Referee: Benito Archundia (Mexico)
| Guatemala | 5–1 | Trinidad and Tobago |
|---|---|---|
| Ramírez 17' Ruiz 30', 38'Pezzarossi 78', 87' |
Report | Edwards 32' |
| United States | 2–0 | Guatemala |
|---|---|---|
| Johnson 11' Ralston 68' |
Report |
Legion Field
Birmingham, Alabama, United States
Birmingham, Alabama, United States
Attendance: 31,624
Referee: Ramesh Ramdhan (Trinidad & Tobago)
Attendance: 8,000
Referee: Mauricio Navarro (Canada)
| Trinidad and Tobago | 2–0 | Panama |
|---|---|---|
| John 34' Lawrence 71' |
Report |
Attendance: 18,000
Referee: Peter Prendergast (Jamaica)
| United States | 3–0 | Costa Rica |
|---|---|---|
| Donovan 6', 62' McBride 87' |
Report |
Rice-Eccles Stadium
Salt Lake City, United States
Salt Lake City, United States
Attendance: 40,586
Referee: Carlos Batres (Guatemala))
| Mexico | 2–0 | Trinidad and Tobago |
|---|---|---|
| Borgetti 63' Pérez 88' |
Report |
| Mexico | 2–0 | Costa Rica |
|---|---|---|
| Borgetti 63' Fonseca 86' |
Report |
Rentschler Field
East Hartford, Connecticut, United States
East Hartford, Connecticut, United States
Attendance: 25,488
Referee: Marco Rodríguez (Mexico)
Attendance: 24,000
Referee: Rodolfo Sibrian (El Salvador)
Attendance: 15,000
Referee: Benito Archundia (Mexico)
| United States | 2–0 | Mexico |
|---|---|---|
| Ralston 53' Beasley 58' |
Report |
Columbus Crew Stadium
Columbus, Ohio, United States
Columbus, Ohio, United States
Attendance: 24,685
Referee: Carlos Batres (Guatemala)
| Costa Rica | 2–0 | Trinidad and Tobago |
|---|---|---|
| Saborio 15' Centeno 50' |
Report |
| Costa Rica | 3–0 | United States |
|---|---|---|
| Wanchope 34' Hernández 60', 88' |
Report |
Attendance: 30,000
Referee: Peter Prendergast (Jamaica)
| Panama | 0–1 | Trinidad and Tobago |
|---|---|---|
| Report | John 61' |
| United States | 2–0 | Panama |
|---|---|---|
| Martino 51' Twellman 57' |
Report |
Gillette Stadium
Foxboro, Massachusetts, United States
Foxboro, Massachusetts, United States
Attendance: 9,192
Referee: Gilberto Alcalá (Mexico)
| Trinidad and Tobago | 2–1 | Mexico |
|---|---|---|
| John 43', 69' |
Report | Lozano 38' |
Attendance: 23,000
Referee: Jose Pineda (Honduras)
| Guatemala | 3–1 | Costa Rica |
|---|---|---|
| É. Ponciano 2' García 16'Ruiz 30' |
Report | Myrie 60' |
There were 83 goals scored in 30 matches, for an average of 2.77 goals per match.
6 goals
4 goals
3 goals
2 goals
1 goal
Whayne Wilson
Freddy García- Élmer Ponciano
- Selvyn Ponciano
- Guillermo Ramírez
- Mario Rodríguez
- Edwin Villatoro
Guillermo Franco- Rafael Márquez
- Ramon Morales
- Pável Pardo
Roberto Brown- Julio Dely Valdés
Carlos Edwards- Angus Eve
- Russell Latapy
- Dennis Lawrence
DaMarcus Beasley- Carlos Bocanegra
- Kyle Martino
- Taylor Twellman
1 own goal
- Gustavo Cabrera (against Mexico)
- Felipe Baloy (against Guatemala)
- Marvin Andrews (against Guatemala)
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