Regional cooperation in the Americas has waned in the fifteen years following the first Summit of the Americas in Miami. The fifth summit was thus convened at a time when hemispheric regionalism in the Americas is at a crossroads. The Centre for International Governance Innovation (CIGI) partnered with the Centre d’Études Interaméricanes (CEI) of Laval University and the Institute of International Relations (IIR) of the University of the West Indies (UWI) to discuss the changing landscape of inter-American institutions, practices and mechanisms. The participants concluded the conference by recommending guidelines for reconstructing the inter-American process in light of recent challenges and changes.