The firebrand populist has used the proceeds of Venezuela's vast oil reserves to prop up left-wing governments and politicians across the region, fomenting anti-Americanism and expanding his personal influence.
Fidel Castro in Cuba, Bolivian leader Evo Morales and Daniel Ortega, the Sandinista revolutionary who returned to power in Nicaragua in 2006, have all benefited from Mr Chavez's oil-fuelled largesse.
But after 10 years in power, Mr Chavez is now fighting an increasingly desperate campaign to win Sunday's referendum on changing the constitution to scrap term limits. His proposal would allow him to stay in office indefinitely if he keeps winning elections run after his current final term expires in 2013.
He has been forced to remove a reported $12 billion (£8 billion) from Venezuela's central bank's foreign currency reserves - one third of its total - to stave off deep spending cuts necessitated by falling oil revenues until after the vote.
The plunge in oil prices is endangering his ability to maintain the free food and health care programmes that secure the support of his power base, the millions of Venezuelans mired in poverty despite the oil bonanza.
Although Mr Chavez controls the levers of political power, opinion polls point to a tight result on Sunday - even before an expected $30 billion gap in the government budget for this year kicks in.
Anti-government protests have intensified despite Molotov cocktail and tear gas attacks by pro-Chavez activists on the offices of opposition political and media figures and harassment of student leaders spearheading the "no" campaign. The Vatican's diplomatic mission was also attacked, in apparent retaliation for granting asylum to a student leader wanted by the government.
"Crunch time is arriving very quickly for Chavez," said Diego Arria, a former Venezuelan ambassador to the United Nations and now a prominent opposition figure. "The treasury is a black hole and he's using the state oil company as his piggy bank to fund his political ambitions. But he cannot keep on like this and he knows it."
Gustavo Coronel, a former board member of the state oil business PdVSA and now a US-based consultant on the region, has produced a devastating analysis of the state of the country's economy.
"Venezuela and Venezuelans are facing a deep economic and social crisis after Feb 15," said Mr Coronel. "The budget is fiction. The economy will contract, inflation will increase, devaluation is inevitable, food shortages will kick in as most foodstuffs are imported and Chavez will be forced to cut back on his handouts to his friends. Make no mistake, this is going to be a very tough year."
Soaring inflation, worsening food shortages and surging crime rates are all undermining Mr Chavez's popularity. Even the heavily-politicised PdVSA, which has been funding his social programmes, has been forced to lay off workers as it struggles with debts of $8 billion.
Independent economic analysts believe that Chavez has called the referendum now because Venezuela's economy is slowing rapidly. Growth fell from 8.5 percent in 2007 to 4.9 percent in 2008 and analysts are forecasting negative growth in 2009 and overall inflation of 45 percent.
Mr Chavez was dealt another major blow last month when the favourite hate figure for his tub-thumbing speeches, US president George W Bush, was replaced by Barack Obama.
The economic crisis is threatening his goal of replacing ailing former Cuban dictator Fidel Castro as America's leading opponent in its Latin American backyard.
He has long sent money, subsidised oil and military aid to his allies in the region, using his largesse to help them win power and fund their regimes. Now he will have to rein in many of those handouts.
Most recently, he has been channelling low-cost oil to an alliance of left-wing mayors in El Salvador in the run-up to next month's presidential election, allowing them to provide cheap fuel to win support or sell it a profit to finance political campaigning. A similar strategy of oil subsidies to Sandanista mayors in Nicaragua paved the way for President Ortega's victory.
The most significant foreign beneficiary is Cuba, which receives 90,000 barrels a day of Venezuelan oil. The impoverished communist state pays "in kind" by sending doctors, military personnel, bodyguards and sports trainers to serve the Chavez regime.
He dispatches another 200,000 barrels a day to other Latin American and Caribbean states at heavily discounted rates or in return for shipments of bananas and black beans. His charity is not limited to oil. A recent trial in Miami threw a spotlight on how Venezuelan agents carrying suitcases packed with dollar bills flew in to Argentina. And his Bolivian protégé, Evo Morales, has received military helicopters and pilots.
Nor has Mr Chavez restricted his handouts to his Hispanic neighbours. He has supplied $400 million worth of home heating oil to low-income residents in eight states in the US, given nearly $20 million to Left-wing US actor Danny Glover to make supportive films, and even sent subsidised fuel for London buses during Ken Livingstone's tenure as mayor.
This year's official budget is based on Venezuela producing 3.6 million barrels of oil per day and selling them at a price of $60 a barrel. But international industry figures suggest the country is only producing 2.5 million barrels a day, selling half of it at the market rate of $32 a barrel and the rest at heavy discounts.
Now facing domestic economic woes, his priority will be to maintain the social welfare programmes with which he keeps the support of impoverished slum-dwellers who have seen little other benefit from the country's oil riches.
Mr Chavez, a charismatic but bullying former paratrooper, was stunned when he narrowly lost a previous referendum in December 2007 to abolish presidential term limits, a tactic widely viewed as a naked power-grab.
He is asking Venezuelans to vote again, although this time he is calling for term limits for all legislators, governors and mayors to be abolished too, apparently hoping that these other political leaders will now also campaign vigorously for a "yes" vote.
Mr Chavez has frequently made clear that he believes he lost the referendum 14 months ago because his campaign was complacent and failed to mobilise his supporters. Those assertions have fuelled opposition fears that he will rely on electoral fraud, intimidation and ballot-box stuffing to ensure victory this time.