Paige Thomas and Vino Alan left the competition following another double elimination.
Thomas was eliminated by virtue of coming bottom in the popular vote, while Alan and Diamond White entered the sing-off. White gave a rendition of 'I Was Here' by Beyoncé, while Alan offered his take on 'Trouble' by Ray Lamontagne.
Alan also said before the sing-off that he did not blame mentor LA Reid for a last-minute change in the song he performed on Wednesday evening (November 28).
LA Reid elected to save his act Alan, but added that he "really, sincerely loved" both acts and was proud of their performances.
"I'm deeply, deeply shocked that we're in this position," he added.
Britney Spears also elected to save her act White, saying that both performers "did an amazing job" during the sing-off.
Demi Lovato said she didn't want to send either act home, but accepted that she had to make a decision, choosing to save White.
Simon Cowell said he felt "exactly the same way as LA", admitting that he loved both artists.
"Both [acts], I've got to tell you, really sang well in that sing-off," he said, but eventually elected to send Alan home.
Alan admitted his shock at the result, and said that he felt sorry he had not been able to show audiences the full extent of his capabilities.
He conceded that the criticism he received for his performance on Wednesday night was valid, but added that he would "stay inspired" and continue to make music.
Reid said following the result: "I'm really proud of Vino, he's come a long way... I'm really happy to call you family at this point in my life."
Alicia Keys was one of this week's musical guests, performing 'Girl on Fire' from her new album of the same name, while last year's X Factor runner-up Josh Krajcik also returned to the show to perform his debut single 'One Thing She'll Never Know'.
Carly Rose Sonenclar topped the public vote for the second week in a row, with host Mario Lopez revealing that just 0.1% of the vote separated her from second-placed Tate Stevens this week.
"I am so proud of you! I couldn't be happier," said Spears after the ranking was revealed.
The X Factor USA airs on Wednesday and Thursdays at 8/7c on Fox in the US, and on Thursdays and Fridays at 8pm on ITV2 in the UK.