Ortega returned to power after an election Sunday that saw him defeat U.S.-backed conservative Eduardo Montealegre with more than 38 percent of the vote.
Ortega promised to usher in peace and to "eradicate poverty and reassure the private sector and international investors," but his task will be hard, according to many who see Ortega trying to balance his close relationship with Venezuelan President Hugo Chavez and Cuban leader Fidel Castro while staying in the good graces of the Americans.
"For the United States, the idea of Cuba, Venezuela and Nicaragua united is a terrible image," former Nicaraguan Vice President under Ortega's Sandinista government Sergio Ramirez told Reuters.
In 1979, Ortega launched a revolution against Nicaraguan dictator Anastasio Somoza, then reigned over a period of bloody civil war during which he fought U.S-backed Contra rebels. About 30,000 people died in the war.
During that time, U.S.-imposed sanctions and mismanagement under Ortega helped leave the country in ruins.
Nicaraguans finally ousted Ortega in a 1990 presidential election that ushered in the first of three conservative U.S.-backed presidents, Reuters reported. Today Nicaragua is second only to Haiti as the poorest country in the western hemisphere.
As he has done with other allies in the region, Chavez has promised aid to Ortega in the form of financing for social programs, according to Reuters. During the presidential campaign, Chavez offered a taste of what such aid would look like under an Ortega-led government by sending cheap fuel and fertilizer.
"This is a poor country. We need schools, oil, jobs," a laborer in Managua, Nicaragua's capital, told Reuters. "Daniel can't do it himself and the Americans won't help him. Chavez will help us."
Chavez has hailed Ortega's victory as a victory for Latin America.
"Now like never before, the Sandinista revolution and the Bolivarian revolution are together," he told Ortega in a phone conversation replayed on Venezuelan state television. "On to build the future, the socialism of the 21st Century!"
In the United States, White House officials said Ortega must embrace democracy in order to win favor.
In Managua, some expressed similar sentiments to those in the United States.
"I don't trust him. With friends like Chavez and Castro, I don't think he has changed," shopper Alejandra Barrios told Reuters. "We don't want to go back to the past. But this man is going to take us there."