The Black Cats are unbeaten in their last nine top-flight meetings with Newcastle dating back to 2011, although the Magpies won an cup tie in 2024.
Eddie Howe found himself on firm footing as he rang the bell.
The Newcastle United head coach had just got the 2023 Great North Run under way to loud cheers in the centre of the city.
But he had failed to anticipate those Sunderland-supporting runners who were less than pleased to see him as they sped past.
"The worst abuse I've ever had," he remarked this week. "I got abused by 50% of the people there."
This is far from an inter-city rivalry. These North East neighbours have won only one significant title between them in the past 50 years, and Sunday's game signals the first time they will meet in the Premier League for almost ten years.
But hardly any fixtures halt an area quite like the Tyne-Wear derby as former Sunderland manager Peter Reid understands better than most.
"They're football crackers," he said. "Let's just say, there is a little bit more needle up there."
'The two biggest games of the season'
Nikos Dabizas also knows what can happen when these worlds collide.
A huge picture in the former Newcastle centre-back's home serves as a daily reminder.
It captures the Greek wild-eyed, shirtless and among his jubilant team-mates, after netting the winner in front of the away fans at the Stadium of Light in 2002.
This was a fixture that definitely made an impression on him.
"The key is the intensity of the fans," he said. "It's something that goes from generation to generation. This heritage makes this game so special."
So what is at the core of the intense rivalry between two one-club cities less than 15 miles apart?
Well, as far as a Sunderland loyal fan is concerned, it transcends football itself.
"You can trace it to the English Civil War with Newcastle siding with the monarchy and Sunderland siding with the government," he said. "It's all political and economic factors.
"Newcastle receive the funding, Newcastle have the big city, Newcastle are the ones people always talk about when it comes to the North East. The other side are always overshadowed."
But it is far from one-sided.
A former player's father was even "swarmed" by joyous Newcastle supporters after his son scored a match-winning free-kick in a 1-0 victory at the Stadium of Light in 2011.
That is how much it meant to the Geordies.
"I needed a little bit of time afterwards to realise the significance of it," the player said.
"It made my life a lot easier. I was forgiven to make the occasional mistake when playing, simply because of that goal.
"I still go up to St James' Park and you've got dads telling their kids, 'See this lad? He scored the winner against our rivals'."
A derby win can even further elevate the standing of an already popular figure.
A former Newcastle manager had recently delivered promotion back to the Premier League when he took charge of his first derby in 2010.
There may have only officially been three points at stake, but he quickly understood the "extra weight" of this game because people in the North East "live for their football".
He said: "There are some derbies where you are not quite sure why they are derbies. This one, you do.
"These represent two huge clubs - close from each other - with their own character.
"In effect, they are the two most important games of the season so you are conscious that the last thing you want to do is to lose, particularly in your own stadium."
A region reignited
That manager had nothing to fear.
His side ended up hammering Sunderland 5-1 at St James' Park in 2010, but Newcastle have only won a single derby in the Premier League since then.
In fact, Sunderland have triumphed in six of the last seven contests in the top flight.
A former Sunderland manager oversaw half of those victories, having swiftly realised that the fixture was "much bigger" than many outsiders thought.
"After family, the club is the most important thing to the people of Sunderland," he said.
"The passion is such that the result of the club can alter the atmosphere of the city so imagine the result of the derby? You can feel it.
"They told me on the first day. 'Please stay up, but you must beat Newcastle'. I still don't know if it was more important to stay up or to beat Newcastle."
Sunderland, like Newcastle before them, eventually slipped through the relegation trapdoor in 2017, and spent eight years outside the top flight.
So a division divided these rivals when they last met in the domestic cup nearly two years ago.
And the contrast was pronounced.
The combined cost of Sunderland's starting line-up that day was a mere fraction of the £40m Newcastle had spent on a single player.
The most experienced individual in the hosts' starting line-up was a clear margin ahead of others, at just 30 years of age.
"I don't think the fans really expected, deep down, that we were going to win that game," a former midfielder said. "But now it's different."
In so many ways.
Only two players are likely to be the only holdovers from that 3-0 defeat in Sunday's lineup following the astute arrivals of several new signings.
Sunderland also have a new manager, of course.
Not only has he led Sunderland to promotion - his fearless side have competed evenly against some the best teams in the top flight.
In fact, the reigning champions are the only team in the current top six to have beaten Sunderland this season, while his side are also undefeated on their own ground.
Such an strong start to the campaign means Sunderland go into Sunday's game a point clear of Newcastle in the table.
So it is all set up to be a gripping afternoon when these rivals renew hostilities at the Stadium of Light.
"On Sunday, the world will know the North East is back on the map with top games again," a former player added.
