This chapter examines the evolving priorities in US relations with Latin America, focusing on trade, migration, organized crime, democracy, and diplomacy. Each administration, from Bill Clinton to Joe Biden, has recalibrated these priorities in response to changing regional and global conditions. Clinton emphasized economic integration and democracy promotion, Bush heightened security concerns post-9/11, Obama focused on diplomacy and economic engagement, Trump stressed immigration control and renegotiated trade agreements, and Biden aimed to address root causes of migration and bolster democracy and human rights. The chapter also discusses the broader context of US foreign policy debates, highlighting the enduring tension between isolationist and internationalist approaches. It underscores the influence of presidential power and the impact of changing global dynamics on US strategy. Additionally, the chapter compares US-Latin American relations with US-EU relations, noting the differences in security commitments and diplomatic approaches. The final sections delve into organized crime and migration, identifying these issues as central to the contemporary US-Latin American agenda. The authors call for coordinated, multifaceted strategies to address these complex challenges.