England’s World Cup dream is hanging by a thread after Luis Suarez scored a goal in each half to earn Uruguay a 2-1 win in Group D in Sao Paulo.
The fit-again Suarez’s first-half header had been cancelled out by Wayne Rooney’s first World Cup goal, only for the PFA Player of the Year to fire home five minutes from time to leave England with only a slim chance of reaching the last 16 following on from Saturday’s defeat by Italy by the same scoreline.
Uruguay captain Diego Godin could be considered fortunate not to have been sent off inside the opening half-hour before Rooney’s header struck the angle of post and bar on 31 minutes.
Suarez, who underwent knee surgery four weeks ago and did not feature in the opening game defeat by Costa Rica, gave Uruguay the lead six minutes before half-time when he headed Edinson Cavani’s cross beyond Joe Hart.
Cavani wasted a golden chance to increase Uruguay’s lead early in the second half, and Rooney was then denied by Fernando Muslera before the Manchester United striker drew England level with 15 minutes left.
Daniel Sturridge freed his Liverpool team-mate Glen Johnson down the right and the full-back got into the box before rolling across a low ball which Rooney tapped in at the far post.
England’s tails were up, but with five minutes left, Gerrard flicked on a long ball into the path of his club colleague Suarez, who thumped his shot beyond Hart.
Roy Hodgson’s side face Costa Rica in their final game next Tuesday and will need to win in Belo Horizonte, in addition to hoping Italy beat the other two teams in the group.
However, if Italy fail to beat Costa Rica on Friday, then England's exit from the World Cup will be confirmed before their last group match.
Despite the opening game defeat by Italy, Hodgson chose the same team that impressed in Manaus, albeit with Rooney playing as number 10 with Danny Welbeck moving to the left flank and Raheem Sterling wide right.
The big news for Uruguay was that Suarez was able to start at Arena Corinthians after undergoing knee surgery last month, replacing Diego Forlan in one of five changes made by Oscar Tabarez to the side defeated by Costa Rica.
This match was played in vastly different conditions to England's opener against Italy, with the heat and humidity of the Amazonian rainforest replaced by a more familiar climate.
England had a scare on five minutes when Hart was unable to prevent a deflected Suarez cross from going behind, with the resulting corner from the Liverpool man set to sneak in at the near post until the goalkeeper's scrambling intervention.
Play settled and Godin was left walking a tightrope after just nine minutes after blocking a Daniel Sturridge flick with his hand, and Rooney curled the free-kick over the wall and inches off target.
Cristian Rodriguez came agonisingly close to exposing England after 16 minutes, with Phil Jagielka's hashed clearance falling into the winger's path and he met it with a fizzing left-footed strike that just cleared the crossbar.
Sturridge saw an attempt loop over due to a timely Alvaro Pereira block, but it was Uruguay who started to edge proceedings.
Hart did well to stop Martin Caceres reaching a free-kick at the far post and soon after Gary Cahill slid in to deny Cavani, whose first-time shot from the resulting corner was not far off.
Godin was fortunate not to receive a second booking for blocking Sturridge with a flailing arm as he attempted to reach a through-ball.
Steven Gerrard then floated in a fine ball to the back post, where Rooney outjumped Caceres and powered a close-range header off the goal frame.
Sturridge sent an audacious effort over and forced Muslera into a save, although the latter opportunity came once Uruguay had scored a 39th-minute opener.
After the ball ricocheted off Gerrard, it was spread out wide to Cavani and, allowed too much space by Johnson, his wonderful chipped pass to the back post was brilliantly headed back across goal by Suarez - who sneaked behind Jagielka.
Neither side made changes for the second half, which was just four minutes old when Uruguay first threatened to double their advantage.
Suarez was again causing the problems, aiming another corner at the near post and forcing Hart into a parry which, fortunately for him, was not straight into the path of an opponent.
A last-ditch Gerrard block stopped Alvaro Gonzalez, with only poor finishing from Uruguay's star men preventing them extending their lead.
First, a fortunate deflection put Suarez through only for him to drag wide, then Cavani ran between the dozy Johnson and Cahill, somehow screwing wide with just Hart to beat.
England were riding their luck and almost capitalised in the 54th minute, as Rooney met a Leighton Baines cross and sent a low strike that Muslera denied with a great save.
Pereira required treatment after taking a knee to the head during a Sterling run - the winger's last contribution before being replaced by Ross Barkley.
Adam Lallana followed him onto the field after Gerrard was booked for a late challenge, with England becoming increasingly frustrated.
Sturridge hit straight at Muslera as hope began to seep away, only for England to eke out the leveller they so desperately craved.
Johnson made great progress down the right and stretched to send a cross through the legs of Gonzalez into the path of the unmarked Rooney, who pounced to stab home inside the six-yard box.
The normally mild-mannered Hodgson punched the air in celebration and was almost doing so again moments later as Sturridge made room to test Muslera.
Again, though, it is not the attack which has been England's issue at this tournament.
This time it was captain Gerrard at fault, accidentally heading towards his own goal under pressure into the path of Liverpool team-mate Suarez, who had broken free of the England backline and rifled home superbly from an acute angle.
The striker raced off in an emotional celebration after the goal which England were unable to find an answer to, with Suarez held aloft by his team-mates at the final whistle.
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