This article examines the expansion of economic, political, and military activities by the People's Republic of China in Latin America and the Caribbean. It examines how the presence is transforming the region, including the reformulation of the agenda of its leaders, businessmen, and publics, changes to its physical infrastructure, new patterns of trans-Pacific organized crime, fuel to extend the life of populist regimes, and impacts on how member countries relate to each other. It also analyzes how the new presence of China impacts US interests in the region and globally, and how China both complements, and at times competes with, other external actors in the region, such as Russia, Iran, and India.