And yet, it happened again.
Polamalu forced a fumble with a sack of Joe Flacco and Roethlisberger converted the turnover into a 9-yard touchdown pass to Isaac Redman with 2:51 left to give the Pittsburgh Steelers a 13-10 victory Sunday night.
With the win, Pittsburgh (9-3) gained sole possession of first place in the AFC North over Baltimore (8-4) and earned a split of the season series.
"Tough place to play, but let's be frank, we needed to come here and even the score in this matchup," Steelers coach Mike Tomlin said. "Thankfully we did, and we'll push on."
A fierce defensive battle turned when Polamalu hit Flacco's arm on a safety blitz. LaMarr Woodley returned the loose ball 19 yards to the Baltimore 9, setting up Pittsburgh's lone touchdown.
Baltimore's ensuing drive ended at the Pittsburgh 31 when Flacco bounced a fourth-down pass to Ed Dickson with 33 seconds remaining.
The game was a defensive battle, as expected. And Polamalu and Roethlisberger again made the difference.
"Everybody watching TV at home, everybody in the stadium, you all know it you see 43 at the line, four-minute offense, he's coming," said Ravens linebacker Terrell Suggs, who had 1½ sacks. "It was just like, I hope we have a plan. It just didn't feel good when I saw that hair at the line."
Polamalu, of course, wears No. 43. And he's done it to the Ravens before -- his 40-yard interception return sealed Pittsburgh's 23-14 victory in the 2008 AFC title game.
Roethlisberger broke his nose on Pittsburgh's first series, was playing with a sprained right foot and was under constant pressure all night. And he still went 22 for 38 for 253 yards.
The rugged quarterback has won six straight starts against Baltimore and is 8-2 in his career against the Ravens. He missed the first game this season while serving an NFL-issued suspension for violating the league's conduct policy.
"That's a Steelers-Ravens game, right? Hard-fought all the way to the end," Roethlisberger said. "Everybody contributes."
He laughingly suggested that his battered nose helped take his mind off his ailing foot.
"It hurt a lot," he said of the foot, "but the broken nose took some of the pain away."
Baltimore blew a fourth-quarter lead for the sixth time this season and had its eight-game home winning streak end.
"Obviously, it was a tough loss. Basically, we gave the game away at the end," coach John Harbaugh said. "We should have won the football game, and that's disappointing."
Flacco was 17 for 33 for 266 yards, but his fumble was the most decisive play of the game.
"It was an all-out blitz. They brought everybody," Flacco said. "I took three steps and raised my arm and was getting hit. It was pretty shocking."
As is usually the case when the Steelers and Ravens meet, the trainers were busy tending to injured players.
Both starting tight ends were knocked out of the game. Baltimore's Todd Heap strained a hamstring on the first play from scrimmage and did not return, and Pittsburgh's Heath Miller suffered a concussion in the third quarter in a collision with Ravens cornerback Chris Carr.
The Steelers also lost right tackle Flozell Adams, who sprained his ankle in the third quarter.
The hitting was so hard that even Pittsburgh's punter got injured. Daniel Sepulveda hurt his right knee in the second quarter, and placekicker Shaun Suisham was called upon to punt for the remainder of the game.
Sepulveda has an ACL injury, Tomlin said, and likely is lost for the season.
Blanked in the first half for the first time since Nov. 26, 2007, against Miami, Pittsburgh got a field goal on the opening drive of the third quarter to close to 7-3. Roethlisberger hit Hines Ward for 13 yards and Mike Wallace for 23 yards before Suisham kicked a 45-yarder.
The Ravens responded with a 60-yard march that ended with a 24-yard field goal by Billy Cundiff.
Pittsburgh then closed to 10-6 with a 16-play, 79-yard drive that consumed more than 9 minutes and was extended by two pivotal penalties against Baltimore. But the Steelers had to settle for a field goal with 12:46 left after a 28-yard pass from Roethlisberger to Wallace set up a first-and-goal from the 2.
Baltimore had two sacks and interception in the first half, and Flacco threw a touchdown pass for a 7-0 lead at the break.
On Pittsburgh's first march, Roethlisberger got his nose bloodied on a third-down sack by Suggs and Haloti Ngata.
Baltimore grabbed the lead late in the first quarter. Flacco went 6 for 6 during a 92-yard drive, completing a 61-yarder to Anquan Boldin on a third-and-15 before connecting with Boldin for a 14-yard touchdown.
On the scoring play, Flacco rolled to his right and had plenty of time to survey the field before finding Boldin in the center of the end zone.
Baltimore's 92-yard scoring drive was the longest against Pittsburgh this season. ... Ravens WR T.J. Houshmandzadeh went over 7,000 yards receiving. ... Steelers RB Rashard Mendenhall ran for 45 yards to break 1,000 for a second straight season.