Danny Granger poured in five points in overtime and finished with 23 overall as the Pacers held off the Cavaliers, 104-98, at Quicken Loans Arena on Wednesday.
Indiana led by four with under 30 seconds left in regulation, but George Hill missed two straight at the line before Tristan Thompson corralled an offensive rebound and converted a three-point play with 7.9 ticks on the clock.
Hill then stepped to the line again, this time making 1-of-2, but Lester Hudson got a running floater to drop in the lane, sending the game to overtime.
The Pacers dominated overtime, though, scoring the first five points and outscoring the Cavs, 10-4, to complete the road victory.
David West tallied 19 points and Hill added 17 for the Pacers, who remain in the third position in the East and have won six of their last seven.
Hudson finished with 19 points, while Antawn Jamison led the way with 21 points and eight rebounds. The Cavaliers, who had won two of three coming in, are now officially eliminated from playoff contention.
With the game tied at 86-86, Indiana opened the third quarter with the first eight points and 11 of the first 13 to take a nine-point edge, but Cleveland countered with a 9-2 surge to pull within 59-58 just past the midway point of the frame.
The Pacers connected on three three-pointers over the final five-plus minutes of the quarter and led by as many as nine before taking a 73-66 edge into the fourth.
The visitors quickly pressed their advantage to 10 on a three-pointer from Dahntay Jones, but 13 straight from the Cavs found the home team on top, 81-78, with just over eight minutes to play.
West finally quelled the run with a free throw to make it a two-point game before Cleveland responded with five straight, increasing the margin to 86-79 at the midway point of the fourth.
The lead was six a minute later after Omri Casspi hit two from the foul line, but a three-pointer from Hill sparked a 9-1 swing, capped by back-to-back layups from Hill to give the Pacers a 91-89 lead with 1:15 left in the contest.
Earlier in the game, a tightly contested first half found the Pacers on top, 28-25, after one quarter, but the Cavaliers battled back in the second half to send the teams into the locker room locked at 46-46.
The two teams will meet again Friday in Indiana...Cleveland rookie guard Kyrie Irving missed his fifth straight contest with a sore right shoulder...The Pacers finished 8-of-20 from three-point range while the Cavaliers connected on 3-of-21 from beyond the arc.