The St Louis Rams and San Francisco 49ers needed overtime for the second time in three weeks.
The 49ers led for much of the game after Frank Gore rushed for an early touchdown.
Janoris Jenkins scored a touchdown for the Rams with three minutes left on the clock, leaving the home side three points down.
Kicker Greg Zuerlein was called on in the final seconds to kick a 54-yard field goal to level the scores.
The 49ers had a chance to win the game in overtime, but David Akers's 51-yard field goal attempt drifted wide.
Zuerlein got another chance for the Rams from 54 yards with just 26 seconds left in overtime. The rookie kicker has made seven out of 11 attempts from over 50 yards this season.
The NFC West rivals played out the NFL's first tie game in four seasons last month at Candlestick Park.
