Clint Dempsey scored the opener after just 30 seconds and German-born John Brooks headed a dramatic winner.
Andre Ayew equalised for Ghana eight minutes before the end. But Brooks’ first goal for his adopted country avenged defeats to the same opposition in the past two World Cups, the latter when Ghana went on to the quarter-finals.
The United States had got off to the dream start as Dempsey sent defender John Boye the wrong way and cut inside the penalty area sending a sweetly struck sidefooted effort into the far corner of the goal.
Dempsey’s strike partner Jozy Altidore wasted a terrific chance in the 17th minute as he dithered too long when well set up and a Ghanaian defender managed to divert his shot for a corner.
Five minutes later Altidore saw his part in the match and probably the World Cup end when he pulled up clutching his left hamstring and collapsed to the ground in agony.
Dempsey too was in the wars as later in the first-half he required minutes of attention after Bowe’s knee connected with his nose as they both went up for the ball prompting a furious reaction from Klinsmann on the sidelines.
Ghana came out with much more purpose in the second-half.
Ghana eventually got the goal they had been threatening to score when a brilliant backheel by Gyan teed up Ayew and he fired it past Howard.
The Americans, though, refused to lie down and Brooks’s brilliant downward header restored their lead for good this time.