The debate over whether the United States has ever exercised hegemonic power globally, and during what periods of time, depends in great measure on the particular school of international theory one subscribes to. Undoubtedly one of the major explanations for the difficulty in ascertaining dates for the reign of U.S. global hegemony is the conflation of the concepts of primacy and hegemony, thereby leading to confusion. With compelling evidence and theoretical clarity, Thomas Andrew O'Keefe presents a much needed reinterpretation of U.S.-American relations, one that utilizes all the international relations theories and conceptions of hegemony and applies them to specific policy initiatives and events most closely associated with the presidencies of George W. Bush and Barack H. Obama. After a discussion of competing theories of hegemony, O'Keefe turns his attention to four concrete examples that manifest a decline in hegemony in the 21st century. The first deals with the diminished relevancy of the inter-American system long championed by the United States as a means of institutionalizing its hegemonic prerogatives. The second examines the failed attempt to establish a Free Trade Area of the Americas by 2005 that would have encompassed all the sovereign states of the Americas (but for Cuba). The third case explores the Energy and Climate Partnership of the Americas. The fourth is the displacement of the United States by the People's Republic of China as a major trading partner and significant source of investment capital in many countries of Latin America and the Caribbean. Other foreign policy initiatives such as Plan Colombia, the Merida Initiative, and the Central American Regional Security Initiative (CARSI) and whether these manifest serious limitations to if not a decline in U.S. hegemony are also discussed. A thought provoking and novel examination that will undoubtedly encourage new ideas and paths of study on U.S. hegemony in Latin America and the Caribbean.