Captain Diego Godin scored in the 81st minute as Uruguay edged 10-man Italy 1-0 Tuesday to reach the second round of the World Cup.
Four-time champion Italy, meanwhile, is heading home after the group phase for the second time in four years.
Godin rose above a crowd of defenders to meet a corner with his left shoulder and veteran goalkeeper Gianluigi Buffon had no chance.
Italy midfielder Claudio Marchisio was shown a direct red card for putting his boot into Egidio Arevalo's knee in the 59th. Mario Balotelli picked up his second yellow card in two matches during the first half then was benched for the second period.
Uruguay finished Group D with six points and Italy goes home with three.