Jason Pominville netted the game-winning goal 2, at First Niagara Center.
Tyler Myers and Thomas Vanek also tallied goals for the Sabres, who won for the seventh time in nine games. Ryan Miller stopped 22-of-24 shots for the victory.
After the Hurricanes failed to take advantage of three power-play opportunities in the third period, including a 40-second 5-on-3 advantage, Carolina's Bryan Allen was called for a hooking penalty with 55 seconds left in regulation.
The Sabres could not capitalize in the third period, but were able to use the 4-on-3 advantage in the extra period to set up Pominville's one-timer from the top of the left circle that sailed into the far side.
The Hurricanes netted the lone goal of the first period just 2:47 into the opening frame when Jussi Jokinen won an offensive faceoff back to Jamie McBain at the left point, where he quickly slid a pass to Spacek at the high slot and he blasted a one-timer past Miller's stick side.
But two quick goals by the Sabres in the second period put them on top.
The first came 22 seconds into the middle stanza after the Sabres raced down the ice on a 4-on-2 rush. Patrick Kaleta took a slap shot from the top of the right circle that was saved by Ward, but Myers was right there to bat the rebound out of the air and into the net.
Jokinen was then whistled for slashing 11 seconds later and Buffalo took advantage at the 1:02 mark of the period when Vanek cleaned up a rebound in front off a Pominville slap shot.
Carolina, though, was able to knot the game at two 5:11 into the second when Jeff Skinner raced down the left side of the ice before sending a pass into the slot from the left circle that deflected off the skate of LaRose as he crashed the net and skipped over the right shoulder of Miller.
The play was reviewed but the goal stood as LaRose made no kicking motion with his skate.
Buffalo improved to 17-11-7 at home this season, while Carolina fell to 8-14-9 on the road...Hurricanes forward Eric Staal did not record a point to snap his 12-game point streak. He had seven goals and 14 assists in the streak...Carolina went 0-for-3 on the power play...The Sabres converted on 2- of-8 power-play chances.