This policy paper examines the scale and nature of organized crime in Latin America and the Caribbean (LAC), highlighting its uniquely violent character. We propose a novel metric—excess lethal violence—that underscores how the region stands out globally in terms of criminal violence. Organized crime in LAC significantly undermines growth, productivity, and social mobility, reinforcing poverty and inequality traps. We argue that while eradicating organized crime is unlikely—just as developed countries coexist with entrenched mafia structures—countries already dealing with entrenched organized crime, as well as those where criminal networks have yet to fully embed themselves, still have a window of opportunity to contain their most harmful effects. The paper outlines four critical policy priorities for the region: (a) prison reform to address their criminogenic nature; (b) improved training and coordination within and across police and law enforcement agencies; (c) reinforced judicial effectiveness, reducing impunity and defining strategic priorities; and (d) international coordination and collaboration. We emphasize the value of emerging research efforts that combine fine-grained data with deep contextual knowledge of LAC’s local dynamics to inform more effective and actionable policy solutions.