As Cuba enters 2022, economic crisis and social tensions loom large. This book chapter written by Laurence Whitehead and Bert Hoffmann reviews the external difficulties that interact with and reinforce the island’s domestic issues. Looking beyond the immediate situation it reflects on underlying international pressures and constraints that will shape the options for the Cuban nation over the next decade. Its analysis encompasses Cuba’s relations with the US and with the EU, as well as those with Venezuela, Mexico, China, Russia and Canada, and it asks to what extent Cuban-made COVID-19 vaccines can re-boost the country’s soft-power projection. Putting the Cuban case in comparative perspective, the island’s regime – and its international profile – are in many ways still unlike any other, and predictive schemas based on false analogies risk being misleading.