Christian Pulisic scored a 114th-minute penalty and substitute goalkeeper Ethan Horvath saved a spot-kick six minutes later as the United States overcame Mexico 3-2 after extra time in a stunning inaugural CONCACAF Nations League final.
Poster boy Pulisic, who ended the 2020-21 campaign as a Champions League winner with Chelsea, converted deep into the second period of extra time after Carlos Salcedo was penalised for a foul following a VAR review on Sunday.
Mexico had the chance to force a penalty shoot-out six minutes later after receiving a spot-kick of their own via VAR, but Horvath – a replacement for injured star Zack Steffen in the 69th minute – denied Andres Guardado.
Extra time was needed after the Nations League decider finished 2-2 at the end of 90 absorbing minutes in Denver, where Jesus Corona's first-minute opener was cancelled out by Giovanni Reyna approaching the half-hour mark.
Mexico thought they had won the trophy thanks to substitute Diego Lainez in the 79th minute but Juventus midfielder Weston McKennie equalised three minutes later to send the match to extra time.
CONACAF Gold Cup holders Mexico were gifted a dream start inside a minute when Mark McKenzie's pass across the penalty area was played into the path of Corona, who fired powerfully past Steffen.
USA looked vulnerable defensively after the self-inflicted wound, though Josh Sargent managed to test Ochoa three minutes later.
Mexico thought they doubled the lead in the 24th minute after Hector Moreno found himself unmarked as he headed home Hector Herrera's delivery, but it was ruled offside following a VAR review.
That was a massive sigh of relief for USA, who went up the other end and equalised two minutes later via Reyna after McKennie's header had rattled the post.
Hirving Lozano wasted a golden chance to restore Mexico's lead two minutes before half-time – the Napoli forward beat the offside trap to find himself in a one-on-one situation with Steffen, but the City goalkeeper was quick off his line.
Mexico continued to be a threat in the second half, however Tata Martino's men had nothing to show for their efforts.
Sargent wasted a great opportunity to put the USA ahead just past the hour mark, but his rebound after Ochoa spilled McKenzie's long-range effort went over the bar.
Ochoa produced a magnificent save to keep the match on level terms, the Mexico goalkeeper diving to keep out McKennie's header with 19 minutes remaining.
Mexico introduced Lainez in the 78th minute and it proved an inspired substitution after drifting onto his left foot and firing into the back of the net a minute later, but the lead lasted just three minutes as McKennie restored parity with a header from a corner.
Extra time was needed, and VAR played a huge role in the second half of the additional period – USA firstly awarded a penalty in the 114th minute following Salcedo foul at the conclusion of a review.
VAR then ruled that McKenzie handled the ball inside the box the 120th minute, but Guardado saw his penalty saved by Horvath in wild scenes.