New figures from the Central Statistics Office show that Ireland exported a total €141 billion of goods in 2018 and imported €92 billion worth of goods.
The country exported over €39 billion of goods to the US in 2018 - its largest export market. It also imported €17 billion from the US last year.
The second biggest export partner was Belgium, with €18 billion of exports.
The CSO said that medical and pharmaceutical products and organic chemicals comprised €25.8 billion, or 66% of the total exports to the US in 2018.
The UK, Germany and the Netherlands complete the list of the remaining top five export markets.
Today's figures also show that imports from the UK were €20 billion in 2018 to make the UK our largest import partner.
They also reveal that food exports to the UK in 2018 were €4.8 billion and accounted for 43% of total food exports.
Nearly half of our food imports came from the UK, at a value of €3.7 billion.
Ireland exported almost €800m of cheese, milk and butter to the UK in 2018, one-third of our total exports of these products.
More than three-quarters of our imports of these products came from the UK, valued at €480m.
The figures also show that we exported over €1 billion of bovine meat to the UK in 2018 and imported €100m.
This accounted for 52% of our total exports and 90% of our total imports of bovine meat.
Ireland also exported over €400m of cereals to the UK in 2018, representing over 90% of total exports of this product.
The CSO noted that almost 80% of all our exports of fruit and vegetables went to the UK, but only 8% of our seafood were exported to the UK in 2018.
Comparing trade figures from 1973 to 2018, the CSO said that food and live animals comprised 41% of Ireland's total exports in 1973, and were valued at €1.1 billion.
Exports of chemical products accounted for just 7% of exports in 1973.
But in 2018, exports of food and live animals were just 8% of total exports, or €11 billion, while chemical products comprise 61% of total exports, or €85.7 billion.