[4] Starting from this edition, League A was increased from twelve to sixteen teams and a new quarter-final round was introduced.

The quarter-finals were played on a two-legged home-and-away basis, with the four winners advancing to the Nations League Finals and qualifying directly to the 2024 Copa América, while the four losers played two single-legged play-in matches for the last two berths to the CONMEBOL tournament.

[5] Cuba, Haiti, and Trinidad and Tobago returned to League A after a one-season absence.

The top four ranked teams (Mexico, the United States, Canada and Costa Rica) were directly seeded in the quarter-finals.

The draw resulted in the following groups:[8] The fixture list was confirmed by CONCACAF on 6 July 2023.

[4] The match-ups were as follows: Each tie was played on a home-and-away two-legged basis, with the order of legs being decided by the four pre-seeded teams that received a direct bye to the quarter-finals (Canada, Costa Rica, Mexico, and the United States).

[35] If the aggregate score is level at the end of the second leg the away goals rule would be applied.

United States won 4–2 on aggregate, advanced to the Finals, and qualified to the 2024 Copa América.

The four teams were ranked based on their results in both legs of the quarter-finals to determine the semi-final matchups.