The devastating storm toppled wooden houses and ripped the roofs off hotels in Belize which has a population of 250,000.
"We've been taking a pounding," said the Prime Minister of Belize, Said Musa. "It's now diminished but we've suffered extensive damage."
While there have been no reports of fatalities in Belize, the hurricane killed people in neighbouring countries.
Floods likely
Hurricane Keith has now been downgraded to a tropical storm but there is still a danger of flash floods as rain continues to pound the country.
Forecasters say continued rainfall could easily exceed half a metre, and could lead to life-threatening floods, similar to Hurricane Mitch, which hit the region two years ago and killed an estimated 9,000 people.
Prime Minister Musa has appealed for international assistance and says Belize urgently needs medicines.
Casualities
The country's infrastructure has been severely affected by the floods.
Belize City is reported to be without power and ankle deep in water.
In Nicaragua 10 people were killed by flooding caused the Hurricane Keith. Most of the victims drowned as they tried to cross swollen rivers.
In neighbouring Guatemala, a young girl is also reported to have been killed.
In Mexico, emergency shelters have been set up to house several thousand people forced from their homes.
Flight to safety
On Monday the authorities in Guatemala granted special visas to 200 people from Belize, who were fleeing the floods.
Several tourists trapped on the Ambergris Cay beach resort have contacted the authorities to say they are safe and well.
A government spokesman Patrick Jones, said news of the tourists' safety was a relief.
"They wanted to communicate with the rest of country that they were all right and that no one had been injured.
"A lot of the structures have been torn off. There's a lot of beach erosion," Mr Jones said.
At its height Hurricane Keith was one of the fiercest storms to pass through the Caribbean this year generating winds of over 200kmh.