The Afghan conflict, America's longest war, is now in its 12th year and both President Barack Obama and his challenger Mitt Romney are stressing their determination to bring the majority of US troops home by the end of 2014.
For some Afghans, ruled by President Hamid Karzai's fragile government and battered by daily Taliban attacks around the country, the end of NATO combat operations raises fears of a return to the bloody chaos of the 1990s.
"If they withdraw foreign troops from Afghanistan, civil war in Afghanistan will start again," Del Agha, a driver aged around 30, told AFP.
"I want from the new US President that NATO forces should stay in Afghanistan a bit longer, till there is good security in Afghanistan."
But analysts say little will change in US policy towards the region regardless of who wins on November 6.
The vast majority of NATO's 105,000 troops, 68,000 of them American, will leave Afghanistan and the country will have to learn to stand on its own feet -- particularly if it is to secure the billions of dollars in foreign aid it wants.
"The idea is that it's time for the Afghans to perform. Our performance in the next years will determine the level of our relationship with the Americans, the level of their financial support," Omar Sharifi of the American Institute of Afghanistan Studies told AFP.
One crucial aspect of the US-Afghan relationship as yet unresolved is the legal status of American forces who remain in the country after 2014.
Washington wants its troops to have immunity from prosecution in local courts, but Karzai says Afghans will not accept that. After failing to secure a similar deal in Iraq, Obama left no permanent US military presence there.
In Pakistan, itself battling rising Islamist extremism, there are fears the NATO withdrawal will mean a surge in violence spilling across the border and an intensification of America's hugely unpopular drone campaign against militants.
While Pakistan publicly calls the missile strikes an infringement of its sovereignty, the United States sees them as a vital tool in the fight against militants allied to the Taliban and Al Qaeda.
Analyst and retired senior army officer Talat Masood said the continuation of the programme would depend on conditions on the ground, not on who occupies the Oval Office.
"If the militants continue their operations within Pakistan and increase their activity in Afghanistan, then of course the use of drones will increase because there is no question of using ground troops," he said.
US-Pakistan relations lurched from crisis to crisis in 2011, first when a CIA contractor shot dead two people in Lahore, then when the US carried out a secret raid to kill Al Qaeda leader Osama bin Laden and culminating in a botched US air strike that killed 24 Pakistani border guards.
Mistrust remains high and the next US President will face a tricky balancing act, trying to continue the process of repairing ties while pressuring Pakistan to do more to tackle extremists in its territory.
In a rare note of agreement during Monday's final presidential debate, Mr Romney backed Mr Obama on the use of drone technology, while the President revealed the depths of the suspicion that bedevils relations with Pakistan.
Touting his high-stakes decision to send US commandos to hunt down bin Laden on Pakistani soil without informing Islamabad, Obama said that "if we had asked Pakistan for permission, we would not have gotten (him)".
For Washington, a major fear is that Pakistan's nuclear arsenal -- which Mr Romney said in the debate would soon exceed Britain's -- could fall into the hands of one of the country's myriad extremist groups.
"Pakistan will be in the eye of the storm and it will be a country on which demand will be placed about its security of its nuclear arsenals as well as increased demands for taking action against militants," said Arshad Sharif, an analyst with the Dunya television station.
With anti-US sentiment running high and an election of their own in the offing next year, no politician in Islamabad wants to be seen cosying up to Washington.
"Like the US we have an election coming up and this anti-Americanism is going to go up because all political parties are also competing to show who is more anti-American," said Raza Rumi of the Jinnah Institute think tank in Islamabad.