Bottom side West Bromwich Albion are almost certain to drop into the Championship which should ensure the three relegation places in the English top flight are not all filled by the big north-east neighbours.
The extent to which fans' hopes have been crushed is shown by expectations going into Monday's Tyne-Tees derby between Newcastle and Middlesbrough at St James' Park.
"It was always going to be a massive game and it'll probably be the case that the loser goes down," Newcastle's interim manager Alan Shearer said. "In the circumstances, the fact that it's a local derby is almost irrelevant.
"It's the biggest game I've been involved in during my career, and that includes playing for England in the semi-finals of Euro 96," added Shearer, without a win during five games in charge in which Newcastle have scored just once.
"The games that will seal our fate are the next two at home, against Boro and Fulham."
Yet the feeling among the two sets of fans is that the local rivals, paralysed by fear of relegation, will battle out a draw that will go a long way to possibly consigning both to the drop.
DOOMSDAY SCENARIO
Such a doomsday scenario would all but end Middlesbrough's 11-year tenure in the Premier League and virtually consign Newcastle to the second tier of English football for the first time since their promotion under Kevin Keegan in 1993.
Sunderland, aiming for a third consecutive season in the top flight, would welcome such an outcome. With only one victory from 10 games going into Saturday's trip to Bolton Wanderers, they are just four points clear of the relegation zone.
With three games remaining, Sunderland have 35 points, Hull City 34, Newcastle and Middlesbrough 31 and West Brom 28.
"The disappointing thing is that when we had a seven-point cushion we didn't push on from there," Sunderland manager Ricky Sbragia said after seeing his side slip from the heights of 10th place they occupied in February.
It is approaching five months since Sunderland last won away but Sbragia added: "It's still in our hands to secure safety. We need to do that as quickly as we can because there's a chance we will be caught."
Boro manager Gareth Southgate said surviving relegation would not necessarily be good for the club even if their revenue in the top flight is far greater than the next tier down.
"If we don't stay in this division it'll have a huge financial implication. But staying in the league, I'm not sure where that would leave us anyway financially," he said.
"From a sporting context we're desperate to stay up to give our fans trips to stadiums like (Arsenal's) Emirates but the long term future of the club will be the most important thing.
"It's incredible that it has all come down to this after 35 games but we always felt the Newcastle fixture was going to be very important. It will be played like a cup tie and when you've got that mixed in with a derby then you know the game will have an extra edge.
