With both teams having lost to pace-setting Japan in recent weeks, USA and Canada will be keen to get off the mark in their clash in Sacramento.
The Brave Blossoms opened the Pacific Nations Cup with a 34-25 win over the Canadians before doubling up against the States, winning 37-29.
And that has left the defeated duo nine and eight points off the pace respectively in the North American conference so Saturday's about pride.
USA did play well in patches against their victors however, with Blaine Scully, Danny Barrett and Chris Wyles starring. The trio start once again.
Barrett will start his second match for the Eagles after earning his first cap last week. He'll replace Cam Dolan, who has an injury, at number eight.
Blindside flanker Todd Clever captains the side, which features impressive Sevens Series finisher Brett Thompson on the wing in his first start.
"We have been looking at him for quite some time," said head coach Mike Tolkin.
"He is an athletic, knowledgeable young man who plays with confidence and has a good amount of ability."
Hayden Smith returns to the line-up to partner Samu Manoa. Smith was not named to the 23-man squad against Japan but played in the Eagles' Series opener against Scotland and the first leg of the IRB Rugby World Cup 2015 Qualifier play-off against Uruguay.
"Hayden was replaced [against Japan] as he is just getting back into things and we thought that the line-up we had versus Japan was the right one for that particular team," Tolkin said. "Hayden brings a lot to the table in ability, knowledge, and pride. I look forward to having him back."
Meanwhile, Canada head coach Kieran Crowley has made four changes to his starting side for Saturday's Pacific Nations Cup clash against their rivals.
In the front-row, Andrew Tiedemann and Aaron Carpenter will feature alongside Jake Ilnicki, which will be the first start for the 22-year-old prop.
The rest of Canada's forwards remain untouched from the Scotland match, with Jamie Cudmore and Tyler Hotson in the second-row and Jebb Sinclair, John Moonlight and captain Tyler Ardron in the back-row.
In the backs, Phil Mack is alongside Harry Jones at number ten. Connor Braid will make his first start of 2014 in the centres next to Ciaran Hearn.
Canada's second all-time try scorer DTH van der Merwe will join fellow professionals Jeff Hassler and James Pritchard in a strong-looking back three.
Ones to watch:
For USA: The combination of Chris Wyles and Blaine Scully was deadly last week against Japan and will again be an attacking outlet for the USA on Saturday. Wyles showed power and pace while Scully proved he's a natural finisher so Canada have been warned.
For Canada: He has been free-scoring in the Sevens Series and got over the whitewash against Japan two weeks ago so USA would do well to keep an eye on John Moonlight. The sizeable flanker forms part of a tough back-row that includes Tyler Ardron and Jebb Sinclar.
Head-to-head: Brett Thompson makes his first appearance for the Eagles and will be focused not only on his own performance but that of Jeff Hassler. Hassler has proven he is the real deal this year at the Ospreys while Thompson was superb on the Sevens Series.
2013: Canada won 13-11 in Toronto
2013: Canada won 27-9 in Charleston
2013: Canada won 16-9 in Edmonton
2012: Canada won 28-25 in Kingston
2011: Canada won 27-7 in Glendale
2011: Canada won 28-22 in Toronto
2009: Canada won 41-18 in Edmonton
2009: USA won 12-6 in Charleston
Prediction: Canada to continue their winning run against USA. Canada by 5.
USA: 15 Chris Wyles, 14 Blaine Scully, 13 Seamus Kelly, 12 Thretton Palamo, 11 Brett Thompson, 10 Shalom Suniula, 9 Mike Petri, 8 Danny Barrett, 7 Scott LaValla, 6 Todd Clever, 5 Hayden Smith, 4 Samu Manoa, 3 Olive Kilifi, 2 Phil Thiel, 1 Nick Wallace.
Replacements: 16 Tom Coolican, 17 Eric Fry, 18 Titi Lamositele, 19 Louis Stanfill, 20 Kyle Sumsion, 21 Folau Niua, 22 Chad London, 23 Luke Hume.
Canada: 15 James Pritchard, 14 Jeff Hassler, 13 Ciaran Hearn, 12 Connor Braid, 11 DTH Van der Merwe, 10 Harry Jones, 9 Phil Mack, 8 Tyler Ardron, 7 John Moonlight, 6 Jebb Sinclair, 5 Tyler Hotson, 4 Jamie Cudmore, 3 Jake Ilnicki, 2 Aaron Carpenter, 1 Andrew Tiedemann,
Replacements: 16 Hubert Buydens, 17 Ray Barkwill, 18 Jason Marshall, 19 Jon Phelan, 20 Kyle Gilmour, 21 Gordon McRorie, 22 Nathan Hirayama, 23 Nick Blevins.
Date: Saturday, June 21
Kick-off: 15:00 local (23:00 BST, 22:00 GMT)
Venue: Bonney Field, Sacramento
Referee: Stuart Berry (South Africa)