What is the utility of US military power when seeking to generate international economic arrangements preferential to its national interests? Conventional theories of relational power, whereby actor A compels actor B against their own will, offers a narrow range of explanations. We argue that theories of structural power, whereby an actor can utilize positional advantages to shape the structural contexts of other states international preferences offers a more nuanced account of the close interaction between geopolitics and the global economy. We taxonomize structural power into positive and negative components, applying these to a case-study of regional American primacy in east Asia. We argue that US primacy has allowed it to leverage its military power into generating political–economic institutional outcomes that have reinforced its broader leadership role. The US may well continue its deep engagement or follow a path of retrenchment under President Trump, but both grand strategic options will impact on its capacity to leverage such structural power and have implications for US hegemony and the region's political economy.