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 | 10 | 7 | 1 | 2 | 16 | 6 | +10 | 22 [a] | 2006 FIFA World Cup | — | 2–0 | 3–0 | 1–0 | 2–0 | 2–0 | ||
| 2 | 10 | 7 | 1 | 2 | 22 | 9 | +13 | 22 [a] | 2–1 | — | 2–0 | 2–0 | 5–2 | 5–0 | |||
| 3 | 10 | 5 | 1 | 4 | 15 | 14 | +1 | 16 | 3–0 | 1–2 | — | 2–0 | 3–2 | 2–1 | |||
| 4 | 10 | 4 | 1 | 5 | 10 | 15 | −5 | 13 | Inter-confederation play-offs | 1–2 | 2–1 | 0–0 | — | 3–2 | 2–0 | ||
| 5 | 10 | 3 | 2 | 5 | 16 | 18 | −2 | 11 | 0–0 | 0–2 | 3–1 | 5–1 | — | 2–1 | |||
| 6 | 10 | 0 | 2 | 8 | 4 | 21 | −17 | 2 | 0–3 | 1–1 | 1–3 | 0–1 | 0–0 | — | 
|  Costa Rica   | 1–2 | |
|---|---|---|
|  Wanchope  | Report |  Lozano  | 
|  Trinidad and Tobago   | 1–2 | |
|---|---|---|
|  Eve  | Report |  Johnson  Lewis  | 
|  Guatemala   | 5–1 | |
|---|---|---|
|  Ramírez  Ruiz Pezzarossi  | Report |  Edwards  | 
|  United States   | 2–0 | |
|---|---|---|
|  Johnson  Ralston  | Report | 
|  Trinidad and Tobago   | 0–0 | |
|---|---|---|
| Report | 
|  Trinidad and Tobago   | 2–0 | |
|---|---|---|
|  John  Lawrence  | Report | 
|  United States   | 3–0 | |
|---|---|---|
|  Donovan  McBride  | Report | 
|  Guatemala   | 0–2 | |
|---|---|---|
| Report |  Sinha  Cabrera  | 
|  Mexico   | 2–0 | |
|---|---|---|
|  Borgetti  Pérez  | Report | 
|  Mexico   | 2–0 | |
|---|---|---|
|  Borgetti  Fonseca  | Report | 
|  United States   | 1–0 | |
|---|---|---|
|  McBride  | Report | 
|  Guatemala   | 2–1 | |
|---|---|---|
|  Baloy  Romero  | Report |  Valdés  | 
|  Trinidad and Tobago   | 3–2 | |
|---|---|---|
|  Latapy  John  | Report |  Andrews  Romero  | 
|  United States   | 2–0 | |
|---|---|---|
|  Ralston  Beasley  | Report | 
|  Costa Rica   | 2–0 | |
|---|---|---|
|  Saborio  Centeno  | Report | 
|  Costa Rica   | 3–0 | |
|---|---|---|
|  Wanchope  Hernández  | Report | 
|  Mexico   | 5–2 | |
|---|---|---|
|  Franco  Fonseca  | Report |  Ruiz  S. Ponciano  | 
|  Panama   | 0–1 | |
|---|---|---|
| Report |  John  | 
|  United States   | 2–0 | |
|---|---|---|
|  Martino  Twellman  | Report | 
|  Trinidad and Tobago   | 2–1 | |
|---|---|---|
|  John  | Report |  Lozano  | 
|  Guatemala   | 3–1 | |
|---|---|---|
|  É. Ponciano  García Ruiz  | Report |  Myrie  | 
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
1 own goal