If familiarity breeds contempt then these two will despise each other given this is the third meeting they've had since the start of December.
It's the 125th meeting of the two clubs but just the second play-off clash, and after years of suffering at the hands of Tom Brady and Bill Belichick the Bills would like nothing more than to send them packing.
The weather is set to be freezing cold in Buffalo but passions will be running high in what looks like a brutal match-up between the fierce AFC East rivals.
The Patriots: Belichick trying Brady trick with rookie QB
You just don't get to a Super Bowl with a rookie QB, it's never happened before, but Belichick is trying to coax Mac Jones through the playoffs behind a fierce defense and run game.
Russell Wilson was the last rookie QB to even win a playoff game back in 2012, and if Jones is to follow him the Patriots will have to run, run and run some more with Damien Harris, and trust their top-two scoring defense to limit Josh Allen and the Bills attack.
And Belichick does have form here - Tom Brady may have been in his second year when he won his first Super Bowl but he made just 14 starts in that season after throwing just three passes in his rookie year, so exactly had less game time than Jones has now.
And it's not like the GOAT was posting huge numbers either as he threw just one TD in the entire post season run, and averaged under 200 yards and exactly 20 points per game. That's exactly the sort of system Belichick is aiming for again.
The Bills: Emerging run game can provide balance
Buffalo's defense is just ahead of England's in terms of scoring, and while they've got the clear advantage in the passing game they've found a much-needed rushing attacking in recent weeks.
Only the Seahawks and Jets have averaged more yards per rush than Buffalo in the last seven weeks, and in the expected cold and difficult playing conditions Saturday night that could come in very handy.
A big concern will be Buffalo's record in close games this season - as they're just the second team since 1989 to win 11 games in a season yet lose all of their games decided by seven points or less.
Bills vs Patriots key stats
- These two rank first and second in points allowed, and also both have 30 takeaways for the season, so points should be hard to come by.
- With 31 playoff wins from 43 games, Bill Belichick has the most of both in NFL history.
- The Patriots are in their 11th post season in 12 years, while it's four out of five for Buffalo, including the last two as AFC East champions - their first divisional titles since 1995.
- New England are second in the league with 24 rushing touchdowns with Damie Harris scoring 15 - tied for second this season.
- The Bills were the only team in the NFL to finish in the top five in total offense and total defense this season.
- Josh Allen is the first player in team history with 4,000 passing yards in consecutive seasons, he's also the first QB ever with six or more rushing TDs in all of his first four seasons.
Bills vs Patriots big match-ups
The last three meetings have gone to the away team so it's clear venue is no real factor - game management is crucial here as we've seen already this season.
Mac Jones threw just three passes as the Patriots ground out a 14-10 victory in torrid wind in Buffalo, before Josh Allen lit up New England in Foxborough as the Bills ran out 33-21 in response.
The Pats can't live with Allen in a shootout, but if they can run for 222 yards as they did on their last trip and control both the ball and the clock then they're in business.
You fancy Jones may have to make more than three throws this time, and although he's had a fine rookie season he's had six turnovers in his last five games - against this Bills defense that won't cut it.
Planet Sport verdict
It's a horrible game to call and a real coin toss that can go either way depending on the flow of the contest. About the only thing I'd put money on is it being a low-scoring fist fight of a contest.
Buffalo have more spark and could recover from a losing position, which makes them worthy favourites, and within anyone else on the opposite sideline you'd back the Bills, but we've learnt a long time ago not to go against Bill Belichick in games like these.
Prediction: Patriots 20-17 Bills