There were a few surprises in both teams' starting line-ups. Sellas Tetteh opted to leave marauding full-backs Samuel Inkoom and David Addy on the bench, with Daniel Opare and Ghandy Kassenu given the chance to impress. For Uruguay, Abel Hernandez was given his first start of the tournament, with Santiago Garcia left on the bench.
It was impossible to split the teams in the first half, with both sharing possession and having two shots on goal each. Uruguay looked clever on the ball and technically very sound, with Ghana looking strong and well organised.
The South Americans signalled their intent to pick up the three points by bossing the early exchanges and almost took the lead in the ninth minute when Adrian Guinino's cross was met by Tabare Viudez at the far post. The midfielder made a good connection with the ball, but knocked it into the ground, reducing its pace and making life easier for Daniel Agyei.
At the other end, Emmanuel Agyemang-Badu's drive from the edge of the box forced a super save from Martin Rodriguez, but then the game lost its way somewhat as the pace dropped and chances dried up. The introduction of Gaston Ramires for Maximiliano Calzada almost paid off immediately for Uruguay, as he started a move which led to a fine chance for Matias Aguirregaray, but his finish was a tame one.
The game desperately needed a goal and Andre Ayew almost provided it by flashing a shot across the face of goal in the 52nd minute, but the African champions did not have too long to wait. Two minutes later, the Ghana captain picked up possession on the edge of the box and slipped the ball to Mohammed Rabiu, who shrugged off the challenges of two defenders before firing past Rodriguez.
Abel Hernandez should have equalised for Uruguay when he dragged his shot wide of the post with just the keeper to beat and, seconds after that glaring miss, Ghana went 2-0 up when Abeiku Quansah crossed for Ransford Osei to score his third goal of the tournament.
Uruguay pulled one back when Ramirez slid the ball through to Nicolas Lodeiro to power a shot into the roof of the net and a minute later the Black Satellites were down to ten men when Mohammed Rabiu was given a straight red card for a high challenge on Aguirregaray. From then on, Ghana moved to protect their lead; Tetteh taking off Osei and Ayew for defenders Gladson Awako and David Addy respectively.
However, in the first minute of added time, Uruguay claimed an equaliser when Lodeiro set up Hernandez, who took his chance well. It set up a frenetic last few minutes, but Ghana held firm to set up a meeting with a third placed team from groups B, E, F, while Aguirre's side must travel to Port Said to meet the winners of Group E, which Brazil currently leads.