After a string of fine saves from US goalie Tim Howard, Belgium went 2-0 ahead in extra-time. The US then pulled one back to set up a pulsating finale.
Thousands packed public viewing areas across the country, despite a kick-off time of 16:00 EST.
Afterwards, the 2-1 defeat was hailed by many as the best game so far.
Leaving Soldier’s Field in Chicago, where nearly 30,000 people watched the drama unfold on big screens, fans said they were “heartbroken” but proud of how the team had played.
It was a magnificent defensive effort, as Belgium launched wave after wave of attacks in the second half but each one foundered as American bodies – most often Howard’s – were flung in the way.
As many as 14 million workers were predicted to down tools to watch Tuesday’s game, costing the US economy more than $600 million in lost labor productivity, according to an estimate by Yahoo Finance.
Even President Barack Obama told reporters he had arranged his schedule around the match.
“I thought I’d get the cabinet together this morning, because we all know that America will be busy this afternoon. Go team USA,” the president said.
Large viewing parties were held across the US, including in Chicago, Kansas City and Washington DC.
At Freedom Plaza in Washington, the city government was hosting a viewing party, where viewers grabbed a spot on the stone plaza in the blistering heat hours before the match.
Team USA’s success in progressing through the so-called Group of Death had driven a wave of enthusiasm for soccer, which typically lags far behind American football, baseball, basketball and ice hockey in popularity.
Even in Texas, traditionally American football country, soccer has taken a hold.
But not everyone will be tuning in. Despite the increased viewing figures, an NBC News poll suggests six in 10 Americans have very little interest or no interest at all in the World Cup. Only 22% had a “great deal” or “quite a bit” of interest.
The US and Belgium had not played each other in the World Cup since the first tournament in 1930, where the Americans won 3-0.
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