Delegates from around 100 countries attending a landmine conference in Oslo formally adopted a draft treaty banning anti-personnel landmines, to be signed in December in Ottawa.
The US rejected the document, arguing that it failed to protect US soldiers, especially on the Korean peninsula, where it had sought a nine-year exemption from enforcing the treaty.
The treaty is aimed at banning the use, sale, stockpiling, transport and production of landmines, which kill or maim 26,000 people a year, mainly in some 50 developing countries struggling to rebuild after the ravages of war.
Princess Diana had advocated a total ban on landmines.
Article One of the draft states: "Each state [party to the treaty] undertakes never under any circumstances to use anti-personnel mines." It defines such mines as those "designed to be exploded by the presence, proximity, or contact of a person and that will incapacitate, injure or kill one or more persons."
President Clinton said on Wednesday he could not "in good conscience add America's name to that treaty" and outlined his own plan for eliminating landmines. It includes eliminating the US landmine stockpile, speeding the development of alternatives, increasing mine-clearing efforts in eight new countries and negotiating an international ban at the disarmament conference in Geneva.
US efforts in those talks would begin with a call for a ban on exports from the largest producers - Russia, China and Iraq - which have refused to sign an international landmine treaty.
The leader of the French delegation, Mr Joelle Bourgois, said France "regrets that we cannot at this point include the US among us in the Ottawa process", adding that the treaty "sends a message of hope to countries' mine victims".
But several countries warned against too much optimism. Russia, attending the conference as an observer, stressed that the treaty "cannot be considered as universal".
The Japanese delegation said there was "still room for improvement".
UNICEF praised the treaty, while expressing disappointment over the US withdrawal.
More than 115 million unexploded mines are concealed worldwide, a number that grows by two million annually. A mine costs about $3 to lay, $10 to produce, but up to $1,000 to remove. Russia, China and India - all suppliers of cheap anti-personnel mines - have not been part of the treaty effort.
South Korea also balked at the draft treaty, saying it needed the million-odd mines scattered across its Demilitarised Zone as a deterrent to attack by North Korea.
In Cambodia, where mines kill or maim 10 people every day, there was whole-hearted support.