The Pacers surged ahead in the third quarter this time.
And when the Miami Heat charged back in the fourth, Roy Hibbert won a showdown at the rim against LeBron James to swing the momentum and send the series back to South Beach.
Paul George had 28 points and eight rebounds, while Hibbert added 24 points and 11 boards in the Pacers' 91-77 win over the Heat in Game 6 of the Eastern Conference finals.
After the Heat outscored Indiana by a 30-13 margin in the 12 minutes after halftime in Game 5, the Pacers held a 29-15 advantage in the third of Game 6 to turn a one-point halftime deficit into a 68-55 cushion heading into the final frame.
"All across the board, they just flat-out beat us. In every facet of the game, they outclassed us that quarter," Heat head coach Erik Spoelstra said of the third.
Miami cut the gap to four midway through the fourth and found itself down 77-68 a bit later before James drove down the lane and met Hibbert at the rim. James double clutched, and Hibbert, who jumped straight up from inside the restricted area, drew an offensive foul when James put his elbow into him.
"That's just him making a huge play at the rim," George said of Hibbert.
A perplexed James sprinted down the floor in disbelief and was assessed a technical foul along with Heat assistant coach David Fizdale.
"I had to run down the court to stop from being kicked out," James said. "I thought it was a pretty bad call. I don't complain about calls too much. I thought me and Hibbert met at the mountaintop. I didn't throw an elbow. Basically I went straight up. And I knew he was going to go high hands, like he had been doing. So I went to a double-clutch to try to let him go down. Then I was able to go over the top. I don't have any idea why that was called an offensive foul."
George Hill sunk the two freebies to extend the cushion back into double figures and Miami never cut the deficit less than 10 the rest of the way.
Game 7 is slated for Monday.
"Execution and making more winning plays than them," Pacers head coach Frank Vogel said of what they have to do to win Game 7. "We have great respect for their culture, their togetherness, their teamwork, their ability to win the plays at the rim, their ability to win loose ball battles, their ability to just reach that level of greatness ... We're going to have to play our best basketball to get a win down there in Game 7."
Battling an upper respiratory infection and a 103 degree fever, David West netted eight of his 11 points in the fourth and grabbed 14 rebounds for Indiana, which held a commanding 53-33 edge on the glass and 44-22 points in the paint margin.
George Hill finished with 16 points and six assists in the victory.
James registered 29 points, seven rebounds and six assists for the Heat, who matched their season-low point total.
Dwyane Wade and Chris Bosh struggled again. Wade tallied 10 points on 3-of-11 shooting, while Bosh had just five points on 1-of-8 from the floor in defeat.
"They're obviously a major part of what we do," Spoelstra said of Wade and Bosh. "Now Game 7s, adversity and backs against the wall, I know those two men's character. This is when they come up big in these moments."
The Heat played without Chris Andersen, who was suspended following his Game 5 incident with Pacers forward Tyler Hansbrough. He knocked Hansbrough to the floor, escalated the altercation by shoving Hansbrough, and resisted efforts to bring the incident to an end.
George netted the final seven points of a 21-5 Indiana run to start the third to give the hosts a 60-45 lead with 4:26 remaining in the frame. Hibbert and Hill also poured in seven points apiece during the surge.
D.J. Augustin's floater along the right baseline gave the Pacers their largest lead of the series at 66-49 before they headed into the fourth with their 13- point edge.
Mike Miller hit back-to-back 3-pointers and James converted consecutive layups to conclude a 17-4 Heat swing to get them within 72-68.
Indiana, though, answered with a 9-0 flurry to put the game away.
George nailed a triple at the other end, West rebounded his own miss and went up for a dunk, James' offensive foul led to Hill's two technical free throws and a Hibbert layup put the Pacers up 81-68 with 3:55 left.
The Heat scored the game's first five points before Indiana answered with the next six. The opening frame remained closely contested and Miami took a 23-21 lead into the second.
The Heat were 6-of-7 from 3-point range in the first.
A 10-0 Indiana spurt in the early stages of the second vaulted the Pacers to a 31-25 lead before the Heat countered with an 11-2 run to take a 36-33 advantage with 3:55 to go in the opening half after Ray Allen knocked down a trey.
Lance Stephenson pulled down 12 rebounds for Indiana ... The Heat shot a season-low 36.1 percent (26-of-72) from the floor, but were 10-of-18 from beyond the arc ... Miami dropped to 1-4 at Indiana this year.