The chapter compares trajectories of regional cooperation in North America as well as in South America with three other regions: Africa, Asia and Europe. It draws on a novel database, the Regional Organization Comptencies datset (ROCO), which covers the development of 75 regional organizations (ROs) between 1945 and 2020. The chapter shows that regionalism has been more dynamic in South America, Africa, Asia and Europe than in North America. While the number of ROs created and the scope of policy competencies these ROs were equipped with is higher in the other regions, North American ROs are characterized by comprehensive membership. NAFTA includes all North American countries as does the OAS, in which South American states are members as well. The chapter ends in discussing reasons behind the particularities of North American regionalism as well as implications for furture governance beyond the nation-state in North America.