Uruguay's goalkeeper Fernando Muslera saves a penalty kick by Ghana's John Mensah during the penalty shootout in the 2010 World Cup quarter-final soccer match at Soccer City stadium in Johannesburg July 2, 2010. [Agencies]

After Gyan missed the ensuing penalty, Muslera kissed his glove and touched it to the bar, and Suarez ran into the tunnel pumping his arms and celebrating the reprieve. He was later hoisted onto the shoulders of his teammates as they celebrated the win.

Coach Oscar Tabarez defended Suarez from suggestions he'd cheated Ghana out of a win, saying his handball was nothing more than an instinctive act.

"He was thrown out of the game, what else do you do with Suarez?" Tabarez said. "Do you blame Suarez for Ghana missing the penalty? I don't like the word cheating. I don't think the word is fair."

Support for Ghana has continued to grow this week as the only one of six African teams in the tournament to progress past the group stage.

Red, yellow and green flags with the black star at its center were all around the stadium as people united to support the last team from the continent still in the first World Cup on African soil.

The partisan 84,017-strong crowd booed loudly when Forlan was successful with the first penalty of the shootout, and cheered wildly when Gyan angled his first shot into the top right corner to make it 1-1.

Ghana captain John Mensah was the first to miss, giving Uruguay a 3-2 cushion, but the Africans stayed alive when Maximiliano Pereira missed the next shot and the crowd cheered wildly again.

But when Adiyiah's next kick was saved by Muslera, Africa's exit was almost sealed.

After Abreu secured the win, Gyan was inconsolable as he left the field in tears.

Uruguay, which won the World Cup in 1930 and 1950 but hasn't been to the semifinals in 40 years, was the fifth and last South American team to qualify for the 2010 edition when it beat Costa Rica in an intercontinental playoff.

Ghana was unable to improve on Africa's best showing at the quadrennial tournament. Cameroon was the first to reach the quarterfinals in 1990 and Senegal matched that in 2002.

Uruguay started strongly, dominating the opening 30 minutes, with Forlan and Suarez finding space and creating opportunities that they were unable to convert.

Kingson stopped Suarez' shot in the 11th and punched away Forlan's 40-yard free kick in the 15th. The goalkeeper then stopped one chance with his face in the 18th after it deflected off Mensah's chest.

Then it was Ghana's turn to attack, with Gyan, Boateng and Muntari having opportunities in the 15 minutes before halftime.

Boateng's was the most spectacular, with his bicycle kick in front of goal to Samuel Inkoom's chipped pass sailing over the just crossbar.

Ghana and Uruguay each had chances to pull ahead in the second half of regulation time, including Suarez' volley at the far post which crashed into the side netting in the 63rd.

Suarez will be banned for at least one match for the red card.

Lineups:

Uruguay: Fernando Muslera, Diego Lugano (Andres Scotti, 38), Mauricio Victorino, Jorge Fucile, Maximiliano Pereira, Alvaro Fernandez (Nicolas Lodeiro, 46), Diego Perez, Egidio Arevalo, Edinson Cavani (Sebastian Abreu, 76), Luis Suarez, Diego Forlan.

Ghana: Richard Kingson, Hans Sarpei, John Pantsil, John Mensah, Isaac Vorsah, Anthony Annan, Samuel Inkoom (Stephen Appiah, 74), Sulley Muntari (Dominic Adiyiah, 88), Kwadwo Asamoah, Kevin-Prince Boateng, Asamoah Gyan.

Ghana's Dominic Adiyiah (R), who missed a penalty kick during the penalty shoot out, and Samuel Inkoom react with dejection after losing the 2010 World Cup quarter-final soccer match against Uruguay at Soccer City stadium in Johannesburg July 2, 2010. [Agencies]