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[a] | 2006 FIFA World Cup | — | 2–0 | 3–0 | 1–0 | 2–0 | 2–0 | |
| 2 | Mexico
|
10 | 7 | 1 | 2 | 22 | 9 | +13 | 22[a] | 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 | — |
| 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' |
| 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 |
| Trinidad and Tobago | 0–0 | Costa Rica |
|---|---|---|
| Report |
| Trinidad and Tobago | 2–0 | Panama |
|---|---|---|
| John 34' Lawrence 71' |
Report |
| United States | 3–0 | Costa Rica |
|---|---|---|
| Donovan 6', 62' McBride 87' |
Report |
| Mexico | 2–0 | Trinidad and Tobago |
|---|---|---|
| Borgetti 63' Pérez 88' |
Report |
| Mexico | 2–0 | Costa Rica |
|---|---|---|
| Borgetti 63' Fonseca 86' |
Report |
| United States | 1–0 | Trinidad and Tobago |
|---|---|---|
| McBride 2' |
Report |
| Guatemala | 2–1 | Panama |
|---|---|---|
| Baloy 70' (o.g.) Romero 90+3' |
Report | Valdés 19' |
| Trinidad and Tobago | 3–2 | Guatemala |
|---|---|---|
| Latapy 48' John 85', 86' |
Report | Andrews 3' (o.g.) Romero 61' |
| United States | 2–0 | Mexico |
|---|---|---|
| Ralston 53' Beasley 58' |
Report |
| Costa Rica | 2–0 | Trinidad and Tobago |
|---|---|---|
| Saborio 15' Centeno 50' |
Report |
| Costa Rica | 3–0 | United States |
|---|---|---|
| Wanchope 34' Hernández 60', 88' |
Report |
| Mexico | 5–2 | Guatemala |
|---|---|---|
| Franco 19' Fonseca 48', 51', 62', 66' |
Report | Ruiz 1' S. Ponciano 53' |
| Panama | 0–1 | Trinidad and Tobago |
|---|---|---|
| Report | John 61' |
| United States | 2–0 | Panama |
|---|---|---|
| Martino 51' Twellman 57' |
Report |
| Trinidad and Tobago | 2–1 | Mexico |
|---|---|---|
| John 43', 69' |
Report | Lozano 38' |
| 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 Twellman1 own goal
Gustavo Cabrera (against Mexico) Felipe Baloy (against Guatemala) Marvin Andrews (against Guatemala)
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