The defending English champions have already conceded their chances in the UEFA Champions League this season and knew that a draw to the North London club would put them four points behind league leaders and rivals Manchester United.
They trailed early courtesy of a header from Steven Caulker and would head into the interval trailing 1-0 to the boos of the their "faithful" home fans.
But like their cross-town rivals, Roberto Mancini's men came from behind courtesy of goals to Sergio Aguero and Dzeko to record a much-needed victory for both their morale and their season at large.
Here are six things we learned from the victory.
Especially in light of City's frustrating night against Ajax in the Champions League, it's clear that Roberto Mancini's men simply aren't getting the rub of the green at the moment.
It's not a conspiracy, and they're not necessarily just poor refereeing decisions all of the time, but City aren't getting the calls—lucky or otherwise—that every team needs to get along the way if they are going to run into success this season.
The defending champions had another clear penalty decision turned down—this time a handball on Tottenham's William Gallas—and seemed to grow in their frustration against the referee and linesman throughout the match.
They just aren't getting those 50-50 decisions.
It might seem bizarre to write anything negative about an attack that features the likes of David Silva, Yaya Toure, Edin Dzeko, Carlos Tevez and Sergio Aguero, but the Citizens simply haven't quite been able to click yet this year as they did last season.
Aguero's finish showed that they can score goals out of nothing, and they do have the attacking depth required to dominate the league again this season, yet still, City aren't quite there.
It won't show up on the stats sheets before and after the game because of the sheer attacking volume that City get through, but they are not as cohesive and "on the same page" as they were last year, or indeed even at times this year.
At their best, we know just how good Manchester City can be.
But they were not at their attacking best today and simply haven't been at all this season. We know they will be, and we know their strike power will dominate sooner rather than later—the only question is as to when it is going to arrive for City.
But seven offsides in the one game?
That's not an attack that's all together just yet.
Andre Villas-Boas started the former Manchester City striker against his old club in this one and would reap the rewards of his inspired decision.
The Toga international was at his attacking best here—carrying Spurs' attack throughout much of the second half—and was without doubt their best attacking option despite the presence of Clint Dempsey and others in the side.
Adebayor, despite playing striker, led Tottenham in pass attempts, pass completions and passes into the attacking third and almost sparked a goal for Tom Huddlestone earlier in the first half with a beautiful run down the left flank.
But perhaps more important than his attacking quality was his ability to get under the skin of Manchester City players—particularly Pablo Zabaleta—and keep his side in the match despite their lack of possession and opportunities.
Jermaine Defoe, Dempsey and the likes of Gylfi Sigurdsson and Moussa Dembele will mean that Adebayor isn't the go-to striker every week for Spurs, and nor should he be.
But he is a great squad player and one who can add a unique edge going forward for the North London club this season—in both Europe and in the Premier League.
Rested by Roberto Mancini following his appearance in the Champions League during the week, Mario Balotelli wasn't even named on the bench for City this week.
And watching City play, you'd have to say he was never missed.
Sergio Aguero and Carlos Tevez are beginning to regather the partnership and form that saw them to the league title last season, and with Yaya Toure and David Silva in behind for the Citizens, their attack flourished throughout the match.
Balotelli offers an impact like no other in world football for Manchester City, but in terms of a starting place in the side, he simply is not needed in big games this year.
Barring injury, of course, Super Mario is not needed this year; whether that brings about a transfer or not this winter is a different point all together.
From the moment Edin Dzeko was inserted into the match at the 73rd minute for Carlos Tevez, you had a feeling that the forward could bag himself another game-winning goal.
The City midfielder or forward—however you want to describe him—played a beautiful one-two with Sergio Aguero to net the game-winning goal with just three minutes remaining—something that City fans and Premier League teams around the league will certainly be getting used to.
Having a player who can come off the bench and have a genuine impact like Dzeko is rare, and it's certainly a big advantage for City throughout the season ahead.
For all the talk of City being a club in turmoil and having problems this year, credit must be given where credit is due, and the defending champions do deserve that.
They have not been beaten in the Premier League this season and sit just two points off league leaders Manchester United with so much of the season to play.
City might have bombed out in the Champions League, but they did so to a group of champion teams (literally and figuratively), and we should not take that away from them.
Having said that, there is little doubt that City are still an agitated club.
Results are not falling their way this year, refereeing decisions are not coming either, and for large portions of this match, they looked unsettled both on and off the ball.
They know the pressure they are under and cannot settle like they did down the stretch last year. Perhaps they deserve credit for sticking in there with the top teams even when the results aren't falling their way.
Roberto Mancini needs to let his team know that they won't always get the lucky calls, and he needs to lead from the front on how to deal with this professionally and respectfully. He hasn't done that so far this year, and you'd argue that it has rubbed off onto his players also.
If City can stay controlled and not get ruffled, then Premier League teams need to seriously watch out. They're getting no luck and are in third place—imagine what they could do once they do start to get those marginal calls that could go either way.
I mean, they haven't even been beaten yet. Even with their luck.
What did you make of the win vs. Tottenham Hotspur?
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