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Costa Rica narrowly emerged as champions on goal difference to win their third title and participate in their first World Cup ever. The United States finished runners-up by virtue of one goal, but qualified for their first World Cup in forty years after beating Trinidad and Tobago in 1–0, with a goal dubbed "The Shot Heard around the World".
A total of sixteen CONCACAF teams entered the competition. However, FIFA rejected the entry of Belize due to debts to FIFA. The North, Central American and Caribbean zone was allocated 2 places (out of 24) in the final tournament.
Five teams qualified from the two stage qualification process that ran from April to November 1988. Mexico were disqualified during this stage after having been found to have fielded over-aged players during the 1988 Olympic Games qualifiers which was a youth tournament. Their scheduled opponents Costa Rica therefore advanced to the Final Round unopposed.
^The El Salvador–Trinidad and Tobago match was played on neutral ground in Honduras instead of in El Salvador.
^The El Salvador–United States match was played on neutral ground in Honduras instead of in El Salvador.
^Both matches between El Salvador and Guatemala were originally scheduled to be played in Guatemala; later it was agreed that they would not be played, due to their lack of importance (neither team could have qualified for the World Cup by winning both matches).
^Both matches between El Salvador and Guatemala were originally scheduled to be played in Guatemala; later it was agreed that they would not be played, due to their lack of importance (neither team could have qualified for the World Cup by winning both matches).