Land of Confusion drew controversy for its portrayal of Ronald Reagan as being physically and cognitively inept. The video features puppets by the British television show Spitting Image. After Phil Collins saw a disfigured version of himself on the show, he commissioned the show's creators, Peter Fluck and Roger Law, to create puppets of the entire band, as well as all the characters in the video.
The video opens with a caricatured Ronald Reagan (voiced by Chris Barrie), Nancy Reagan, and a chimpanzee, going to bed at 16:30 (4:30 pm). Reagan, holding a teddy bear, goes to sleep and begins to have a nightmare, which sets the premise for the entire video. The video intermittently features a line of stomping feet, illustrating an army marching through a swamp, and they pick up heads of Cold War-era political figures in the swamp along the way.
Caricatured versions of the band members are shown playing instruments on stage during a concert: Tony Banks on an array of synthesizers, Mike Rutherford on a four-necked guitar, and two Phil Collins puppets: one on the drums, and one singing.
During the second verse, the video features various world leaders giving speeches on large video screens in front of mass crowds; the video shows Mussolini, Ayatollah Ruhollah Khomeini, Mikhail Gorbachev and his aides, and Muammar al-Gaddafi. Meanwhile, Reagan is shown putting on a Superman suit, fumbling along the way.
During the bridge, the Superman-costumed Reagan and a Monoclonius-type dinosaur watch a television showing various Spitting Image clips, including Johnny Carson, Leonard Nimoy as Mr Spock, and Bob Hope. This segues into a sequence apparently set in prehistoric times, where the Monoclonius-type and a Theropod-type dinosaur meet up with Ron and Nancy Reagan and a rather outlandish mammal eats an egg and reads a newspaper. At the end of this part, the ape from the prologue is shown throwing a bone in the air.
As the bone begins to fall there is a sudden switch to Collins catching a falling phone which he uses to inform the person on the other end that he "won't be coming home tonight, my generation will put it right" and on the "we're not just making promises" verse the bone lands on top of David Bowie and Bob Dylan. Reagan is then shown riding the Monoclonius through the streets while wearing a cowboy hat and wardrobe. As the video nears its climax, there are periodic scenes of a large group of spoofed celebrity puppets, including Tina Turner, Michael Jackson, Madonna, and Hulk Hogan singing along to the chorus of the song, in a spoof of the charity driven song "We Are the World".
At the end of the video, Reagan awakens from his dream, and surfaces from the sweat surrounding him; Nancy at this point is wearing a snorkel. After taking a drink, which misses his mouth, he fumbles for a button next to his bed. He intends to push the one labeled "Nurse", but instead presses the one titled "Nuke", setting off a mushroom cloud. Reagan then replies "Man, that's one heck of a nurse!" Nancy whacks him over the head with her snorkel.
The video won the short lived Grammy Award for Best Concept Music Video during the 1988 Grammys. The video was also nominated for an MTV Video Music Award for Best Video of the Year in 1987, but lost to "Sledgehammer (Peter Gabriel)" by Peter Gabriel.
Land of Confusion features the band's mascot, the Guy, who leads the people in rebellion against world powers. They confront the real power behind the politicians, a gigantic, bloated Fat Cat, who the Guy destroys into a shower of dollar bills.