Cape Verde took a surprise 21st-minute lead as Kevin Pina scored their first World Cup goal from a free-kick, only for Uruguay to strike twice shortly before half-time through Maximiliano Araujo and Agustin Canobbio.
But 40-year-old Uruguay goalkeeper Fernando Muslera’s mistake allowed Helio Varela to grab Cape Verde’s second just after the hour mark and neither side could find a winner.
Cape Verde boosted their hopes of reaching the knockout phase with their second point in Group H.
The African island nation face Saudi Arabia, thumped 4-0 by Spain earlier Sunday, in their final group game next Saturday, knowing victory would secure a last-32 berth.
Two-time world champions Uruguay’s hopes of progressing are in serious danger, though, after again being held by lower-ranked opposition after their 1-1 draw with the Saudis.
The South Americans may need to beat European champions Spain next weekend to avoid a second consecutive World Cup group-stage exit.
Uruguay coach Marcelo Bielsa made two changes to the team which were held by Saudi Arabia, with Al Hilal striker Darwin Nunez dropping to the bench.
Bubista opted for three alterations to his Cape Verde team, all in attacking positions.
Cape Verde started with more intent going forward than they were able to show against Spain, but it was still Uruguay who created the first real opening when Federico Valverde drilled a left-footed shot wide.
But the tournament debutants forged ahead when Pina crashed a long-range free-kick through a poor Uruguay wall and past Muslera.
Uruguay were in desperate need of their equaliser when it arrived in the 44th minute.
Sidney Lopes Cabral headed the ball against his own post under pressure from Rodrigo Bentancur, and Araujo stooped to nod in the rebound with Cape Verde goalkeeper Vozinha stranded.
They completed the turnaround in the sixth minute of first-half added time, as Canobbio turned in Araujo’s header across goal on the volley.
Uruguay appeared in control early in the second half until Muslera inexplicably raced out of his goal in the 61st minute and Cape Verde substitute Varela took full advantage to roll the ball into an empty net after an excellent first touch.
Vozinha, the hero of Cape Verde’s draw with Spain, fumbled to allow Araujo to tap in, but his blushes were spared by an offside flag.
Real Madrid midfielder Valverde blazed a late free-kick over the bar from just outside the box, leaving Uruguay on the brink of a hugely disappointing exit. (AFP)