The Americas have a long history of managing fermentation to produce food and beverages. Because maize is such a widespread and culturally important food resource, it has historically been a basic substrate for fermentation by the cultures that inhabit these areas. Fermented maize beverages (FMB) are components of food systems, are present in ritual celebrations, their sale contributes to family livelihoods, and are part of the biocultural heritage of the communities. This research seeks to diagnose the current conditions of production, transformation, and consumption of FMB in the Americas. Eighteen FMB have been identified, which were categorized into three groups: non-alcoholic acidic beverages, alcoholic beverages from maize fermentation, and alcoholic beverages with added sugars. It was possible to identify 73 maize races used in the production of these beverages. For the biocultural conservation of the FMB, the strategies should consider the following: the creation of fair and accessible commercialization spaces, the strengthening of the productive and organizational capacities of the producers, and a documentation that allows the reconnection of the beverages with the people and their territories. It is necessary to give priority to the integral conservation of FMB because they are strategic resources for the food sovereignty of rural and urban communities in the Americas.