In this book, titled in the original Spanish as Las Venas Abiertas de Latino America, Galeano expresses his historical vision of his continent, Latin America, and how, as the subtitle states, it has been based on nothing more than "five centuries of pillage." He begins his history by focusing on how, almost straight after Columbus "discovered" the Americas, the white colonists embarked on a frenzied project of colonialism that was based on the goldlust that they suffered from seeing necklaces of gold adorned on the bodies of the indigenous population. It explores how systematically the colonists exploited both the people of Latin America and its raw materials, enriching themselves at the expense of the indigenous population. Galeano's history continues into the 18th and 19th centuries by arguing that the way countries were structured and set up was not for the benefit of the populace but for the benefit of the colonial powers that controlled them. Note the following example:

Railroads formed another decisive part of the cage of dependency: when monopoly capitalism was in flower, imperialist influence extended into the colonial economies' remote backyards. Most of the loans were for financing railroads to bring minerals and foodstuffs to export terminals. The tracks were laid not to connect internal areas one with another but to connect production centres with ports.

Whatever "good" the colonists did, Galeano thus argues, was not altruistic, but rather based on selfish greed and exploitation as they sought to drain the blood from this continent. Galeano thus persents a very strong and cogent left-wing and socialist vision of Latin America's history which clearly chooses to look at Latin American history from the perspective of how it has been exploited by European powers. It ends with something of a challenge:

The Latin American cause is above all a social cause: the rebirth of Latin America must start with the overthrow of its masters, country by country. We are entering times of rebellion and change. There are those that believe that destiny rests on the knees of the gods; but the truth is that it confronts the conscience of man with a burning challenge.

Such a view of history is clearly not without its problems: whilst Galeano focuses on the harm and damage wrought by the relations between European colonialists and the indigenous population, it seems to ignore the reality that so many Latin American countries now have become so hybrid that it is difficult to identify the "masters" that must be overthrown. Many people of European extraction have settled in countries in Latin America for years now and therefore consider themselves to be Argentinean or Chilean, for example. In addition, it ignores the economic success in recent years of countries such as Argentina and Brazil. Arguably therefore, as compelling as this history is, there are areas of its presentation of Latin American history that can be questioned.