Buffalo again came up big in the fourth quarter only this time it was their defense providing the points. Following a tackle for loss by Paul Posluszny on 1st-and-10 at the Rams 13, Trent Green moving away from pressure threw an errant pass that was picked off by Jabari Greer along the near sideline. Greer sprinted to the opposite side of the field for a 33-yard touchdown return to give Buffalo a lead they would not relinquish as they scored 18 unanswered points en route to their fourth straight victory to start the season 31-14 over winless St. Louis.
The Bills defense then shut the door on the St. Louis offense sending them three-and-out on the following possession, and Trent Edwards and company put the Rams to bed with an efficient five-play 81-yard drive together finishing with a 39-yard touchdown pass from Edwards to Lee Evans giving Buffalo a two touchdown edge (28-14).
The offense would later tack on a 45-yard Rian Lindell field goal for a 31-14 lead, as a Bills offense that struggled in the first half scored 17 points on three of their first four second half possessions to erase a 14-6 halftime deficit.
Edwards finished the game 15-25 passing for 197 yards a touchdown and an interception along with a passer rating of 81.6.
The Bills are now 4-0 to start the season matching their 4-0 start in 1992.
The Rams tried to get things going on their first offensive play from scrimmage sending rookie Donnie Avery on a fly pattern down the right side of the field, but Terrence McGee was stride for stride and almost pulled in the interception.
Buffalo's defense got pressure on Trent Green early as Paul Posluszny came on a center blitz hitting just as Green got rid of the ball on a 3rd-and-3, forcing the Rams three-and-out.
The Bills took over at their own 19-yard line following the punt return by Fred Jackson who replaced the injured Roscoe Parrish along with Leodis McKelvin. On their first play Buffalo also dialed up a big play and got it when Trent Edwards hit Lee Evans in stride down the left sideline for a 49-yard gain. Though a holding penalty stalled the drive at the Rams 27-yard line, Rian Lindell put a 45-yard attempt between the uprights for an early 3-0 lead.
But St. Louis answered right back as an end around by rookie Donnie Avery went 37 yards for a touchdown to gave the Rams their first points of the season in the first quarter and a 7-3 advantage.
Following an exchange of possessions the Bills got a 35-yard punt return from Jackson to set the offense up 1st-and-10 at the Rams 29. But Buffalo could manage only a 35-yard Lindell field goal to pull within one late in the first quarter (7-6).
St. Louis would get the touchdown back as Steven Jackson capped an eight-play 60 yard drive with a 29-yard scoring run in which he ran up the middle before breaking out to the near sideline reaching the end zone untouched for a 14-6 second quarter edge.
Buffalo's offense had trouble cutting any further into the St. Louis lead the rest of the half as the Rams defensive line effectively controlled the line of scrimmage. The St. Louis run front plugged up the rush lanes and were getting consistent pressure on Trent Edwards, who late in the half threw an interception deep down the left sideline.
The Rams were unable to capitalize further despite a drive start at midfield as Buffalo's defense forced a turnover on downs. However, Trent Edwards and company couldn't move the ball themselves. A 27-yard run by Marshawn Lynch to the Rams 23 was called back on a tripping penalty. That was followed by a sack of Edwards on a delayed blitz call.
Fortunately Brian Moorman pinned the Rams inside their own 15-yard line to prevent them from putting any more points on the board in the waning seconds of the second quarter.
Since they deferred on the coin toss, Buffalo had the first possession of the second half and showed their best rhythm of the game. The Bills leaned heavily on both Marshawn Lynch and Fred Jackson as they provided 57 of the 76 yards on the drive with all but three coming on the ground. Jackson capped the drive with a sharp-looking 22-yard touchdown run up the middle, the first of his career.
Jackson then followed up with an two-point conversion run, but it was called back on an illegal formation penalty, so Buffalo elected to kick the extra point and trailed by one early in the third (14-13).
Buffalo's defense clamped down on Steven Jackson on the ensuing possession and Donte Whitner recorded his first career sack on a safety blitz on a 2nd-10 from the Bills 25 dropping Trent Green for a loss of 13. Even though the Rams got five yards back on a draw play on 3rd-and-23, it wasn't close enough for Josh Brown who pushed a 51-yard field goal attempt wide right.
St. Louis defensive coordinator Jim Haslett continued to call blitzes to keep the heat on Edwards and the passing game and it was successful as he sent six pass rushers on a 3rd-and-9 at the Rams' 45 and forced an incompletion and ultimately a Bills punt.
But that's when Green's errant pass was returned by Greer, swinging the game in Buffalo's favor for good.