The 2010 FIFA World Cup CONCACAF–CONMEBOL qualification play-off were a series of two-legged home-and-away ties between the fourth-placed team of the CONCACAF qualifying tournament, Costa Rica, and the fifth-placed team from the South American qualifying tournament, Uruguay.

In the first leg, held in San José, Uruguay beat Costa Rica 1–0, while in the second leg played at Estadio Centenario in Montevideo, both teams tied 1–1.

Uruguay won the series 2–1 on aggregate and qualified for the 2010 World Cup.

It was the third consecutive FIFA World Cup play-off that Uruguay has participated in after 3–1 on aggregate win over Australia for Korea/Japan 2002 and losing to Australia 4–2 on penalties for Germany 2006.

The draw for the order in which the two matches would be played was held on 2 June 2009 during the FIFA Congress in Nassau, The Bahamas.