After thumping relegated Pescara in midweek, Max Allegri restored probably his strongest available XI for this clash, making five changes bringing in Mattia De Sciglio, Philippe Mexes, Massimo Ambrosini, Kevin-Prince Boateng and Stephan El-Shaarawy for Ignazio Abate, Mario Yepes, Antonio Nocerino, Robinho and M'baye Niang. After slumping to a miserable 1-0 defeat to Chievo in midweek, Aurelio Andreazzoli made four changes with Ivan Piris, Daniele De Rossi, Miralem Pjanic and Mattia Destro making way for Marquinho, Simone Perrotta, Michael Bradley and Erik Lamela.
In the early exchanges, it was Roma who were more effective going forward, Marquinho looking particularly lively testing Christian Abbiati twice in the first ten minutes, once with a 25 yard thunderbolt and once with an angled drive from the right hand side.
Kevin Constant didn't have the best of starts, giving the ball away in dangerous positions twice, the second time straight to Francesco Totti who drove into the box, but his shot sailed well over when he should've done better.
Whilst Milan were able to gain some possession, chances were hard to come by and Sulley Muntari's shot from distance after 26 minutes was their first real effort, although Bogdan Lobont saw it go comfortably over the bar.
On the half hour mark, Mattia De Sciglio was able to burst down the right hand side and played a tantalising ball across goal. Kevin-Prince Boateng was on hand to meet it but his effort was straight at Lobont and the Romanian was able to spark a quick counter attack which culminated in Totti unleashing a piledriver from distance that Abbiati had to be alert to parry away.
Mario Balotelli's free kick from around 30 yards was parried away by Lobont before big controversy gripped the San Siro. Balotelli clattered into Marquinhos after the Brazilian had cleared the ball and the referee blew for the foul. He approached Balotelli in order to show him a yellow card however he was confronted by an enraged Sulley Muntari who physically attempted to stop him accessing the cards in his pocket by grabbing hold of his arms. The referee had no option other than to send the Ghanaian off after eventually issuing Balotelli with his yellow.
Early in the second period, the referee suspended the match following racist chants from the Roma fans. Francesco Totti was sent over to speak to them and a PA announcement was played in order to suppress the chants, as is the new procedure in Serie A. It appeared to work as the match went ahead without any further interruptions.
With a man advantage, Roma were really looking to take advantage and Pablo Osvaldo was dropping deeper in order to attempt to create himself some chances as the service just wasn't there. He did manage to fashion an effort, but it flashed wide of Abbiati's post.
Francesco Totti and the lively Marquinho exchanged passes, with the Brazilian beating the on-rushing Abbiati to the ball to flick towards goal, but Philippe Mexes was back to head clear when the ball looked destined for the net.
Roma began to look as if they'd run out of steam and opportunities became harder and harder to come by, the match itself becoming a scrappy midfield affair with both sides committing a raft of fouls. Mathieu Flamini had a chance to put Milan in the lead when he was threaded into the box but Lobont was able to get down smartly to save and hold it at the second attempt.
As the match wore towards its conclusion, Roma were only able to threaten from long range, with substitute Miralem Pjanic having two efforts, one that sailed over the bar and one that forced a save out of Abbiati.
There was late drama in two counts - Erik Lamela was blatantly taken down in the penalty area by Kevin Constant and in clear view of two of the referee's assistants however a potentially match-winning penalty was denied and Milan survived. The sides were then evened up as Francesco Totti clearly elbowed his former team-mate Philippe Mexes, earning himself a straight red card and ensuring the match ended even in more than just the score.
Milan: Abbiati; De Sciglio, Zapata, Mexes, Constant; Muntari, Flamini (Pazzini 80), Ambrosini; Boateng (Nocerino 78), El Shaarawy (Robinho 71), Balotelli
Roma: Lobont; Marquinhos, Leandro Castan, Burdisso; Marquinho (Florenzi 74), Bradley, Perrotta (Pjanic 70), Dodo; Lamela, Totti; Osvaldo (Destro 81)
Sent off: Muntari 41 (M), Totti 90 +1 (R)