Otto Perez Molina, a former army general who has promised an "iron fist" against criminals, is leading the field of 10 candidates as Guatemalans cast ballots for a new president.
Crime, violence and the economy have been the biggest campaign issues for voters in the Central American nation of 14.7 million people who will vote on Sunday.
"We are afraid all the time of the criminals," Mario Rojas, a resident Guatemala City, the capital, told Al Jazeera. "We are afraid of ourselves or our children being murdered."
All government institutions had been placed on a 48-hour "orange alert" before the voting.
Lucia Newman, Al Jazeera's correspondent in Guatemala City, said "violence provoked by gangs, organised crime and drug traffickers has made the country one of the most dangerous in the Western Hemisphere".
Drug cartels, most commonly from Mexico, are using Guatemala as a shipping route, resulting in regular fighting and other violence between rival gangs.
Analysts claim the murder rate of 45 per 100,000 people shows that violence is as bad or worse today than it was during Guatemala's 36-year civil war which killed an estimated 200,000 people.
A UN-sponsored truth commission found that 93 per cent of those killings were carried out by state forces and paramilitary groups during a war in which leftist rebels fought various military dictatorships and the economic elite.
Perez Molina, 60, was a military general during the fighting, but he also played a role in negotiating the 1996 peace accords that ended the conflict.
"What we have to do is to re-gain control of our national territory and our institutions and confront these criminal organisations that generate more than 45 per cent of violence. Security and justice are my priorities," Perez Molina told Al Jazeera in an interview.
Molina leads his nearest rival, populist businessman Manuel Baldizon, by about 20 per cent in pre-election polls. Baldizon has promised to carry out more executions, possibly in public, and said Guatemala's national football team would make the World Cup if he was elected.
A candidate needs to win 50 per cent of the vote to avoid a November run-off, an unlikely total given the crowded field. The new president will take office in January.
The three leading candidates are all conservatives. The only candidate on the ballot considered a leftist is Rigoberta Menchu, an indigenous activist and Nobel Peace Prize laureate who looks set to win about two per cent of the vote.
About half of all Guatemalans live in poverty, and the indigenous and rural poor are disproportionately affected by current trends of violence.
Alvaro Colom, the current president, is not vying for another term. His wife, Sandra Torres, divorced Colom in an attempt to circumvent a law banning close relatives from running for the presidency, but a court ruled that she was still ineligible.
The next president will face massive challenges in a country unable to create well-paying legal jobs for its young population, Al Jazeera' Newman said.
Newman added that unless the new leader could reduce crime, inequality and other social problems then "central America's most populous country could inch even closer to what some are calling a failed state".