Republic of Ireland captain Robbie Keane came off the bench to rescue Tottenham after Middlesbrough almost snatched a point at White Hart Lane.
Keane fired home from long range in the 84th minute, just three minutes after coming on to seal a precious 2-1 victory.
Boro centre-back Robert Huth had cancelled out Dimitar Berbatov's spectacular opener just after the break.
And, in a hot-tempered end to the game, Didier Zokora and George Boateng were both dismissed following a melee on the touchline.
In the night's other game, an El Karkouri free-kick with five seconds left of stoppage time earned Charlton three points and lifted the team off the foot of the Premiership after a 1-0 home win over Blackburn.