The Buffalo Bills, the American Football Conference (AFC) champions for the previous two seasons, recorded an 11–5 record during the 1992 regular season and finished in second place in the AFC Eastern Division. Buffalo's no-huddle offense led the league in rushing yards (2,436) and ranked second in the league in total offensive yards (6,114 yards).
Meanwhile, the Houston Oilers finished in second place in the AFC Central Division with a 10-6 record. Houston's Run & Shoot offense led the league in passing (4,231 yards) and its defense ranked third in the league, allowing only 4,532 total yards. Overall, the team boasted nine pro bowl selections.
The Bills and Oilers had faced each other for the final game of the regular season, with Houston defeating Buffalo, 27–3 in Houston. During that game, Bills starting quarterback Jim Kelly suffered strained ligaments in his knee, leaving backup quarterback Frank Reich to finish the game in his place. With Kelly out, Reich took the reins starting in place of Kelly the following week in the wild card game. Buffalo hosted Houston, having a better record. Reich also started the following divisional playoff game in Pittsburgh in which Buffalo also won 24–3, then advancing to the AFC Championship game the following week versus the Miami Dolphins.
Houston dominated the game early, as quarterback Warren Moon completed 19 of 22 passes for 220 yards and 4 touchdowns in the first half, while the Oilers held the ball for 21:12, keeping the Bills high powered offense off the field for most of the first two quarters. In the first quarter Moon completed 6 of 7 passes on an 80-yard scoring drive and ended it with his first touchdown throw was to wide receiver Haywood Jeffires for 3 yards to give the Oilers a 7–0 lead. Then after Buffalo kicker Steve Christie made a 36-yard field goal, Moon led the Oilers on a second quarter scoring drive that was nearly identical to their first one, completing 6 of 7 passes on another 80-yard drive and finishing it with a 7-yard touchdown pass to Webster Slaughter. Then after forcing the Bills to a three-and-out, Moon threw a 26-yard touchdown pass to Curtis Duncan. Later on with 1:15 left in the half, the Oilers drove for another touchdown, aided by an encroachment call against the Bills on fourth down and 1. Moon completed the drive with his second touchdown pass to Jeffires, this one a 27-yarder, and the Oilers went into their locker room with a 28–3 halftime lead.
Corey decided to switch from a 4-3 to a 3-4 defense, helping to contain the Houston passing offense.
Meanwhile, head coach Marv Levy told his team "You've got thirty more minutes. Maybe it's the last thirty minutes of your season. When your season's over you're going to have to live with yourselves and look yourselves in the eyes. You'd damn well better have reason to feel good about yourselves, regardless of how this game turns out."
Apparently, the words of Corey and Levy didn't have any immediate effect. 1:41 into the third quarter, Oilers defensive back Bubba McDowell intercepted Reich's first pass of the second half and returned it 58 yards for a touchdown. Houston now had a commanding 32-point lead, 35-3.
A Houston radio announcer was immortalized on NFL Films with the statement "The lights are on here at Rich Stadium, they've been on since this morning, you could pretty much turn them out on the Bills right now."
The Bills got a huge assist to start their comeback on the ensuing kickoff. The wind altered the ball just before it was kicked by Al Del Greco. As a result, it became an unintentional squib kick that the Bills recovered with great field position at midfield. Buffalo then drove 50 yards in 10 plays and scored with a 1-yard touchdown run by Davis, cutting the deficit to 35–10. On the drive, Reich completed a 24-yard pass to tight end Pete Metzelaars and a 16-yard strike to Andre Reed, while Davis kept the drive going with a 5-yard run on fourth down and 2 before finishing it off with a touchdown run.
Christie then recovered his own onside kick and the Bills scored on the fourth play of their ensuing drive with Reich's 38-yard touchdown pass to wide receiver Don Beebe, making the score 35-17 with 7:46 left in the third quarter.
Houston was then forced to punt for the first time in the game on their next drive, and Greg Montgomery's 25-yard kick gave Buffalo the ball at their own 41-yard line. Reich started out the ensuing drive with an 18-yard completion to James Lofton. Davis gained 20 yards on a screen pass and then Reich threw a 26-yard touchdown pass to Reed, trimming the lead, 35–24. In a span of 10 minutes in the third quarter, the Bills had run 18 plays, gained 176 yards, and scored 21 points, while holding the Oilers offense to 3 plays for 3 yards.
The situation wasn't about to get any better for Houston. On the first play of the Oilers' ensuing possession, Bills safety Henry Jones intercepted a pass from Moon and returned it 15 yards to the Houston 23-yard line. Three plays later, Buffalo faced fourth down and five on the 18-yard line. Rather than attempt a field goal, Reich connected with Reed for the touchdown. With the score, the Bills had cut their deficit from 32 points to four in a span of just 6:52. On the Oilers' next drive, linebacker Darryl Talley forced a fumble from Moon while sacking him. Houston recovered the fumble, but it was forced to punt, and Montgomery's 24-yard kick gave Buffalo the ball at its 48-yard line. In the third quarter, Buffalo had outscored Houston 28–7 while holding Moon to 2 of 7 completions for 19 yards.
This time, the Bills could not take advantage of their excellent starting field position and had to punt, and Moon's run and shoot offense began to move the ball effectively again, aided by a roughing the passer penalty on Bruce Smith that negated linebacker Carlton Bailey's interception. Despite two sacks by Wright on the drive, Houston reached the Buffalo 14-yard line. Al Del Greco attempted a field goal to increase the Oilers' lead, but Montgomery fumbled the snap. Talley recovered the ball and returned it 70 yards, but officials ruled him down by contact when he made the initial recovery, giving Buffalo the ball on their own 26-yard line. After two plays, the Bills faced third down and four. With Houston's defense dropping back and expecting a pass, Reich handed the ball off to Davis, who stormed through the line and took off for a 35-yard gain. Only a diving tackle from defensive back Steve Jackson prevented Davis from taking it all the way for a touchdown. Then Reich went back to passing the ball, completing a short pass to Reed at the Oilers 17-yard line on third down and two for the first down. With just 3:08 left in the fourth quarter, Reich threw a 17-yard touchdown pass to Reed, giving Buffalo its first lead of the game 38–35. But Moon led Houston downfield on a 63-yard drive to score the tying 26-yard field goal from Del Greco to send the game into overtime. A key play on the drive was an 18-yard completion to Slaughter on fourth down and four from the Bills 34-yard line.
Houston won the coin toss and got the ball at its 20-yard line. Moon started out the drive with two completions for 7 yards, but his 50th pass attempt of the day turned out to be his last. On third down and three, Moon threw a pass intended for Ernest Givens five yards downfield, but due to a struggle with Talley, Givens could not get his arms up to make the catch. The ball went over his head and right into the arms of defensive back Nate Odomes for an interception. After a 2-yard return, Jeffires committed a 15-yard facemask penalty while making the tackle, giving the Bills a first down on Houston's 20-yard line. After two runs by Davis, Christie kicked a 32-yard field goal to give Buffalo the win, 41–38. Buffalo would win the following two AFC playoff games to advance to the 3rd of their four consecutive Super Bowl appearances.
Reich finished the game with 21 of 34 pass completions for 289 yards and 4 touchdowns, with 1 interception. Reed had 8 catches for 136 yards and 3 touchdowns. Davis rushed for 68 yards and a touchdown, while also catching 2 passes for 25 yards and returning a kickoff for 33. Moon recorded 36 of 50 completions for 371 yards and 4 touchdowns, with 2 interceptions. Givens caught 9 passes for 117 yards. Jeffires recorded 8 catches for 98 yards and 2 touchdowns.