Gerrard lost the ball, but Suarez's goal owed much to his deft lay-off to Cristian Rodriguez and then to Edinson Cavani's smart run. Even more so, Cavani then waited, unchallenged, until Phil Jagielka was foolishly drawn to the ball and Suarez drifted away from him.
The trigger was then pulled. Cavani crossed and Suarez steered his header back across Joe Hart and into the net. His celebrations included a hug for the Uruguay physiotherapist who danced along the touchline and who had worked so hard with him to bring about this comeback.
England winced just as Suarez had winked, pre-match, in the tunnel, to Gerrard in the knowledge that at 50 per cent - 75 per cent at most - capacity he could still inflict damage or at least give that impression.
He made a psychological difference to both sides. England were fearful; Uruguay believing, with Cavani transformed by the presence of Suarez.
This was no classic encounter; it was several notches below England's match against Italy but Uruguay were cajoled and berated by Suarez for failing to close their opponents down quickly enough, even though there was barely a yard of space in that fiercely contested midfield.
Suarez is always about movement and aggression; skill and cleverness. Lots of cleverness, such as when he improvised two first-half corners. In the opening minutes he sowed a seed of doubt for England after he won a corner and almost caught out Hart - again an unconvincing presence - who had tried to anticipate the cross. Instead Suarez bent the ball in low to the near post and attempted a shot which was just about clawed out.
For the second, Suarez quickly dragged the ball back to meet Cavani's late, uncovered run only for his fellow striker to steer his shot over. Before that and Suarez had shrugged Gerrard off the ball as the pair met shoulder-to-shoulder and instigated another counter-attack.
The fact that Suarez was not fit was also evident. He could not burst in behind the England defence and did not hunt down Jagielka or Gary Cahill if the ball was played too far in front of him. At full capacity he would have chased every lost cause with an edgy ferocity.
But what was not dimmed was his game awareness and ability to discomfort opponents. He wouldn't let England settle with a nudge here, a sly push there and also used his strength and intelligence to make angled runs that spread panic.
Not that this Uruguay side were impressive. They were semifinalists in the World Cup four years ago, they won the Copa America in 2011 and reached the last four of the Confederations Cup last year but it's a team in decline with Suarez, 27, the one who is raging against the dying of the light.
His contribution, and Uruguay's performance, confirmed a line used by Michael Owen in his column for the Daily Telegraph. They are like an ordinary boxer with a haymaker punch, the former England striker said. And Suarez was that hammer blow. By halftime he had left England dazed and confused and staring at an early exit from this World Cup.
Gerrard knew. England knew. Everyone knew it was Suarez who could be the Uruguayan to wreck England's summer, while the decision of coach "scar Tabarez" not to send him on against Costa Rica in that wretched defeat was baffling even if he wasn't fit. Was he really being held back for this match? Maybe the goal was vindication of that but it was a big gamble.
Uruguay scented blood and Suarez went for the kill. Crazily, Hart hurtled from his goal to anticipate another corner and again Suarez almost caught him out as he went for goal. Hart just about recovered. Then Suarez had a sight of Hart's goal but dragged his shot wide before Cavani should have scored when put clear.
England were reeling; their desperation growing. Wayne Rooney drew them level but then Suarez struck again, running on to Cavani's flick-on to thrash his shot beyond Hart. It was a great goal to score and a shocking goal to concede. Either way, it had to be Suarez.
