Tottenham's Champions League ambitions were hit by former player Darren Bent who scored twice in an amazing contest.
Bent smashed home a rebound after just 34 seconds and added a penalty into the bottom corner for his 23rd goal of the season after Kyle Walker handled.
Incredibly Bent also saw two penalties saved by Spurs keeper Heurelho Gomes.
Anton Ferdinand had an effort ruled out, substitute Peter Crouch headed Spurs back in contention but Boudewijn Zenden's stunning volley sealed it.
Many Spurs followers believed the formidable forthcoming succession of matches against Chelsea, Ars*nal and Manchester United would decide their fate in their quest to break into the top four for the first time in the Premier League.
But this was always likely to be a tough trip for the Londoners, who had not won in their previous fours visits to the Stadium of Light, with Sunderland beaten only once in their last 15 home league matches.
It was perhaps inevitable that Bent, discarded by Spurs last summer, would be fired up for this one, but he managed to inspire his team-mates to greater heights as well in an electrifying start by the home side.
The absence of Jonathan Woodgate, Ledley King and Michael Dawson left a huge void in the Tottenham defence and there was certainly plenty of space as another former Spur Frazier Campbell swooped to meet Kieran Richardson's corner.
Gomes kept out the point blank header but it fell perfectly for Bent, who became Tottenham's record signing when he joined them for £16.5m from Charlton in June 2007.
The 26-year-old, who scored 25 goals in 79 games for the Lilywhites, 36 of which were as substitute, rammed home the close range rebound emphatically and took great delight in celebrating the fastest Premier League goal of the season in front of the travelling Spurs contingent.
With the visitors unable to find any foothold in the game, Jordan Henderson jinked through into the area and fell under challenge from Benoit Assou-Ekotto but the claims were waved away by referee Lee Mason.
But when a cross brushed Walker's arm midway through the half the referee did point to the spot for the first time, and Bent confidently beat Gomes to his right.
Sunderland were simply first to every loose ball, Lee Cattermole had no grievance against Spurs but he snapped at the heels of former Wigan team-mate Wilson Palacios throughout.
Campbell wriggled clear of the attentions of Sebastien Bassong and Assou-Ekotto and burst into the box, before being felled by an appalling forward's challenge from Luka Modric, who simply hung out a leg.
Bent opted to put the ball to the left of Gomes this time and the Brazilian leapt across goal magnificently to tip the ball away.
Not surprisingly, an incensed Harry Redknapp made two changes at half-time, Jermain Defoe and Niko Kranjcar brought on for Assou-Ekotto and Bentley.
Defoe was soon bursting through on goal but a rather tame effort was kept out by Gordon.
With Spurs beginning to look more threatening going forward, Gareth Bale's glancing header from a Modric corner was smartly tipped over by the Scottish keeper and Defoe flicked another effort inches wide.
Any momentum the visitors might have been building was halted by another rash challenge, this time by Palacios on David Meyler.
Bent, who missed a penalty on his return to White Hart Lane in November when Spurs beat Sunderland 2-0, struck his third spot-kick of the afternoon to the right of Gomes, but the Tottenham keeper tipped the ball on to the inside of the post and was relieved to grab the rebound.
Ferdinand looked to have sealed it when calmly side-footed a loose ball into the bottom corner after a cross from the third former Tottenham player in the Sunderland starting line-up, the influential Steed Malbranque, caused yet more problems.
However, referee Mason ruled that Campbell was holding down Gomes in the melee.
Crouch replaced the enigmatic, and on this occasion ineffective, Roman Pavlyuchenko, and the England striker scored with his first touch when he rose to meet Kranjcar's looping cross from the left.
But there were several chances for the home side to make the game safe, substitute Kenwyne Jones completely missing his kick in front of goal and Zenden seeing two efforts blocked.
It seemed as though Spurs might be reprieved and would make Sunderland pay for their profligacy, but the final key moment in this astonishing game came from Zenden, who acrobatically volleyed into the top corner following Henderson's looping cross.
The goal would have been cheered as loudly by Liverpool, Manchester City and Aston Villa followers as the race for the coveted fourth place took another twist.
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