Boro came out on top in both of this season's derbies at the Riverside, but can the Black Cats grab a much needed three points over their North-East rivals with the threat of back-to-back relegations looming?
Forget bragging rights - Sunderland need points
Having lost the last five fixtures against Boro you might think Sunderland would be itching to get one over on their rivals, but given the position they find themselves in this season bragging rights are the least of their worries.
Chris Coleman's side slipped to the bottom of the Championship table following Tuesday evening's 1-0 defeat away to relegation rivals Bolton Wanderers coupled with Burton Albion's victory over Barnsley.
Sunderland are now four points away from safety with 13 games remaining and given they have won just five games all season, things are looking increasingly dire for a side who up to now have only ever played one season in the third tier of English football.
The departure of top-scorer Lewis Grabban in January has taken its toll with loan signing Ashley Fletcher yet to score in a red and white shirt - a stat which will continue as he is unable to play against parent club Middlesbrough this weekend.
Coleman has attempted to take the pressure off the game this weekend by admitting in his pre-match press conference: "I don't think this is a derby for us."
He went on to say that Boro are "a team down the road who are fighting for different things to us" and admitted that they will be "the fancied team" given their position in contrast to that of the Black Cats.
Boro looking to make it six in a row
While their opponents are in desperate need of points to keep their Championship status, Middlesbrough have the opportunity to gain ground on the play-offs while also making it six wins in a row against Sunderland.
A 2-0 win in the Emirates FA Cup and a 1-0 win in the Championship at the Riverside earlier this season ensured that Boro retained bragging rights in the fixture, and with Tony Pulis' side just three points outside of the play-offs his players should require no extra motivation ahead of Saturday's clash.
Boro have suffered from inconsistent from in recent weeks, winning two of their last five games while losing their last two away fixtures against Cardiff and Norwich - a feat they hope not repeat at the Stadium of Light.
Attacking pair Patrick Bamford and Rudy Gestede were on form in the win over Hull City last time out with the pair both getting on the scoresheet, keeping club top-scorer Britt Assombalonga on the bench in the process.
Pulis spoke of the "real disappointment" following the news that Gestede is set to miss the rest of the season with an ankle injury this week, saying the forward "looked most likely to score" in recent weeks.
Sunderland are without Marc Wilson and Kazenga LuaLua, while Darron Gibson is making progress in his efforts to recover from groin surgery but is not ready to play. Ovie Ejaria and Adam Matthews remain doubtful and will be assessed closer to kick-off, while Fletcher is unable to play against his parent club.
Middlesbrough are without Gestede following the news of his season-ending ankle injury, although Ben Gibson is set to return to the side after missing the Hull game in midweek.
Sunderland (5-3-2): Camp; Oviedo, O'Shea, Koné, Browning, Jones; Honeyman, Ejaria, McGeady; Asoro, Maja.
Middlesbrough (4-3-3): Randolph; Friend, Gibson, Ayala, Shotton; Bešić, Leadbitter, Downing; Bamford, Assombalonga, Traore.