Organised crime is not new to Latin America, but in recent years, homicide rates have surged beyond a few hotspots, affecting the entire region. Countries like Ecuador, Uruguay, and Argentina, which were previously considered safe, have witnessed a sharp rise in homicides linked to organised crime. In Ecuador, 91% of the 8008 homicides recorded in 2023 were tied to criminal violence, while in Uruguay, 56% of homicides between 2012 and 2022 stemmed from conflicts between criminal groups. Beyond security concerns, organised crime undermines public institutions, weakens governance, hinders economic development, and erodes democracy. This chapter examines three key factors driving this phenomenon: (1) the expansion of transnational criminal groups and the fragmentation of local organisations, intensifying violence; (2) governance failures that enable organised crime due to weak, corrupt, or ineffective state institutions; and (3) the reconfiguration of drug trafficking routes and the growth of local illicit economies, reshaping criminal dynamics.