Described as a female icon and the most powerful woman in US politics, here is a look at Nancy Pelosi's rise to power.
Twelve years ago, Nancy Pelosi made history as the first woman elected speaker of the US House of Representatives.
On Thursday, the tough-as-nails Democrat once again became America's most powerful elected woman in a comeback for the political history books.
Keeping Donald Trump in check will be among her top challenges as she presides over the House through the 2020 elections, when her party aims to dethrone the Republican commander-in-chief.
Following November's election that saw Democrats win back the House, she is again the nation's third most senior official and one of the great survivors in American politics.
To reclaim the speaker's gavel she lost eight years ago, the 78-year-old California power broker diligently plotted a remarkable comeback that has impressed her allies and opponents alike.
"She's a worthy adversary," congressman Mark Meadows, chairman of the conservative House Freedom Caucus, told AFP.
"Ideologically, we couldn't be further apart," he added. "But you know, at this point, elections have consequences."
On Thursday, a smiling Pelosi -- resplendent in red -- won the floor vote over top Republican Kevin McCarthy.
In her opening speech to a new Congress, she said she was "particularly proud" to take the gavel with a record number of women lawmakers on Capitol Hill and in 2019, 100 years after American women secured the right to vote.
That she is the new speaker in the #MeToo era -- and the opponent-in-chief to a brash president accused by multiple women of abuse or harassment over the years -- reflects the increasing influence of women on the nation's political process.
'They need each other'
Nancy Patricia D'Alesandro was born in March 1940 in Baltimore to a political family with Italian roots. Both her father and brother were mayors of the East Coast port city.
After studying political science in Washington, she moved with her husband to San Francisco, where they raised five children.
First elected to the House in 1987, Pelosi represents California's 12th congressional district including San Francisco -- a stronghold of left-wing politics, counter-culture and gay rights regarded by many heartland conservatives as a true Gomorrah.
She rose through the ranks to first become minority leader for the Democrats in 2003.
Pelosi assumed the speakership for the first time in 2007, during the presidency of George W Bush. She was a strong opposing force to the Republican leader, and her role as a check on Trump will be similar.
But she will also need to tightly corral her own caucus, where some progressives are seeking swift punitive measures against Trump in the coming months.
In her reprised role, she will have to thread a political needle, standing up to Trump when needed but also showing that her party is capable of working with the president to pass legislation.
"I think they both know that if they're going to do some of the things that they need to do, they need each other," House Democrat Debbie Dingell said.
Pelosi and the Democratic leadership would have the power to block Republican legislation, hamstringing large parts of Trump's agenda ranging from proposed new tax cuts to building a wall on the border with Mexico.
And Pelosi could make life miserable for Trump if she uses subpoena power to compel administration officials to testify before Congress or turn over key documents -- or if she launches impeachment proceedings.
So far, she has spoken out against using such a powerful political cudgel against him, arguing that the explosive step would likely mobilize Republican voters eager to protect the president.
Pelosi's immediate task? Finding a way to help end a standoff over Trump's border wall demand that has led to a partial government shutdown that is nearly two weeks old.
'Don't do that to me!'
Pelosi is unquestionably among the savviest political leaders of her generation. She shepherded then president Barack Obama's signature health care law through the House to its contentious, historic passage in 2010.
Perhaps for that reason she is vilified by Republicans.
Conservatives depict Pelosi, the wife of an investment millionaire, as the embodiment of a leftist elite.
She is accused of everything from wanting to raise taxes for middle-class families to supporting a massive influx of illegal immigrants.
"Can you imagine Nancy Pelosi as speaker of the House?" Trump asked a crowd at a Minnesota rally in October. "Don't do that to me!"
Within her own party, resistance stems from Pelosi's broad unpopularity among voters. She was forced to navigate simmering party unease that saw dozens of House Democrats and candidates signaling a desire for change at the top.
But in an interview published Wednesday, she pushed back at the notion that she is reviled.
"I don't necessarily feel hated. I feel respected," she told Elle magazine. "They wouldn't come after me if I were not effective."
Dingell says Pelosi has developed a thick skin to weather the constant attacks, describing her friend as "a tough lady."