San Francisco would lose Alex Smith in the second quarter but would hold on to a 24-24 tie with their divisional rivals, St. Louis.
Clock mismanagement and penalties plagued the Rams and kept them from picking up a victory in overtime. Danny Amendola had an 80-yard catch negated on the first play in the period by an illegal formation. A delay of game would also negate a 53-yard field goal made by Greg Zuerlein. He would miss the following 58-yard kick.
St. Louis had a 14-0 lead to start the game. Despite controlling the clock more in the second half and overtime, the Rams were unable to hold on to the lead. They owned time of possession for 40:21, compared to 34:15 by the 49ers.
With Colin Kaepernick under center, the 49ers' comeback began on the first turnover right after the 49ers scored their second touchdown to make it 17-14. Isaiah Pead fumbled the ball on the kickoff return and Darcel McBath recovered it for San Francisco to the Rams' 20-yard line. Frank Gore would then turn the corner on the very first play from scrimmage and run it down the sideline to make it a 21-17 lead for the 49ers.
St. Louis responded with Amendola grabbing five big catches on the ensuing drive, and Austin Pettis would get the two-yard touchdown catch. In their second punt fake in the drive, Johnny Hekker would pass another first down completion to keep it alive.
Kaepernick and the 49ers wouldn't give up, and David Akers would kick a field goal to tie the game in regulation.
Sam Bradford finished the game going 25-of-38 in the air for 251 yards and two touchdowns. Steven Jackson was beast on the ground, picking up 101 yards and a touchdown on 29 carries.
In comparison, both Smith and Kaepernick had 189 yards in the air, completing 18-of-25 passes, and Smith had the first touchdown pass of the game for the 49ers. Kaepernick also ran the ball for 66 yards on eight carries and picked up a touchdown himself.
This would be the first tie game in the NFL since November 16, 2008 when the Philadelphia Eagles and Cincinnati Bengals ended in a 13-13 tie. Donovan McNabb, then quarterback of the Eagles, is infamously known from this game as not knowing about the NFL rules on a game being called a tie at the end of the overtime period.