The Bills and Patriots played for the first time in a preseason game during the first season of the American Football League on July 30, 1960. The game was played at War Memorial Stadium in Buffalo, and the Patriots won the game 28–7. The teams met for their first regular season game during Week 3 of the inaugural season of the American Football League in 1960. The game was played at Nickerson Field at Boston University on Friday, September 23, 1960. The Bills scored a touchdown in each of the first two quarters and shut the Patriots out 13–0.
The two teams met for their first and only playoff match in the AFL divisional game in December 1963. The Patriots won 26–8. In this game, Jack Kemp played quarterback for the Bills and Gino Cappelletti made four field goals and two extra points to help lift the Patriots to victory.
Throughout the remainder of the decade, the teams would complete a 12–9 record in favor of the Patriots. The Bills won the AFL championship game in 1964 and 1965, and won the division in 1966. The Patriots lost to the San Diego Chargers in their only championship appearance in 1963.
In the 1970s, the two teams played each other in the NFL, after the AFL–NFL merger. During this time period, the Bills defeated the Patriots 12 games to 8. The Bills sustained a winning streak of 9 games from 1971 to 1975. The two teams played a pair of highly competitive games in the 1974 season. The Bills withstood a late Patriots rally at Rich Stadium to win, 30–28, on October 20. Two weeks later on November 3 the Bills edged out the Patriots, 29–28, when a last-second field goal attempt by the Patriots was blocked.
O.J. Simpson had one of the most dramatic games of his career on November 23, 1975 against the Patriots. Simpson ran in two touchdowns and caught two touchdown passes from Joe Ferguson as the Bills won, 45–31. Patriots rookie Steve Grogan threw for 365 yards and two touchdowns but was intercepted three times.
1976 was his final year in Buffalo; on October 24 Simpson rushed for 110 yards and two touchdowns in a 26–22 Patriots win. Two weeks later on November 7 Simpson was held to just eight rushing yards and was ejected following a scuffle at midfield; Patriots rookie Mike Haynes ran back a second quarter punt 89 yards for a touchdown, the first such touchdown in Patriots history. The Patriots won the game, 20–10, their first season sweep of the Bills since 1968.
The 1980s was a dominant decade for the Patriots, with New England winning the decade series 13–6. The Patriots also completed their own 11-game winning streak over the Bills from January 1983 to September 1988. The Bills began to rebuild their team in the late 1980s with the additions of Jim Kelly at quarterback, Thurman Thomas as running back, Andre Reed as a receiver, Bruce Smith on defense, and Marv Levy as coach. The Bills bested the Patriots to win the AFC East division four years in a row from 1988–92. During the final stretch of the 1980s, the Bills took three out of four meetings with the Patriots.
In the 1990 season, the Bills reached the Super Bowl for the first time, playing against the New York Giants in Super Bowl XXV. Although obviously not a game in the rivalry, the 1990 Giants were coached by Bill Parcells (who had been linebackers coach with the Patriots in 1980) and defensive coordinator Bill Belichick; both would become head coach of the Patriots. The Giants won 20–19.
The Bills continued to dominate the Patriots in the first part of the decade, winning eight of the first nine games, including five straight. New England, however, made the rivalry more competitive with the addition of Drew Bledsoe as quarterback and the hiring of Parcells as head coach. The Bills also saw many of their Super Bowl players leave during this time period. By the end of the 1990s, the Bills led the decade with 12 wins to the Patriots' 8 wins. Throughout the decade, the two teams combined to win the AFC East six times, with the Patriots reaching the Super Bowl in 1996 and the Bills reaching the Super Bowl in 1990, 1991, 1992, and 1993.
The decade saw several memorable games between the two. On September 11, 1994 the Patriots, under new team owner Robert Kraft, hosted the Bills; Buffalo led 28–14 at the half and 35–21 at the start of the fourth quarter after Mike Lodish grabbed a Patriots fumble at the New England goalline. The Patriots scored two touchdowns to tie the game but Buffalo won 38–35 after Steve Christie booted a 32-yard field goal at the end of the fourth.
Late that season the Bills hosted the Patriots; Buffalo was 7–7 while the Patriots were 8–6. Buffalo's run of playoff appearances ended when the Patriots erased a 17–3 gap, scoring 38 unanswered points. Frank Reich, replacing Jim Kelly, was intercepted twice and the Bills fumbled three times; Ricky Reynolds ran back a Buffalo fumble for a touchdown. The 41–17 Patriots win eliminated Buffalo from the playoffs.
In 1995 the Patriots authored their first season sweep of Buffalo since 1987. The Patriots won on Monday Night Football on October 23, winning 27–14. Then on November 26 the Bills at Rich Stadium clawed to a 25–13 lead after three quarters, but in the fourth Bledsoe threw two touchdowns to Ben Coates, then Chris Slade scored on a Kelly interception and a 35–25 Patriots win.
1996 was Jim Kelly's last season; his Bills won 17–10 on September 8 at Rich Stadium on a 63-yard touchdown throw to Quinn Early and then on a last-second goalline stand. On October 27 at Foxboro Stadium the Bills clawed to an 18–15 lead at the two-minute warning; Curtis Martin ran in a ten-yard score, then Willie McGinest intercepted Kelly and ran in a 46-yard touchdown, but Kelly then completed a 48-yard touchdown off two Patriots defenders to Andre Reed; the onside kick failed and the Patriots won 28–25.
The 1998 season saw the return of Doug Flutie, who'd been Patriots quarterback in 1988–89; he replaced Rob Johnson as Bills quarterback after Buffalo started 1–3. Flutie led the Bills to win four of his first five starts, including a 13–10 victory over the Patriots at Rich Stadium on November 15, but on November 29 in Flutie's return to Foxboro Stadium the Patriots, despite a broken index finger for Drew Bledsoe, rallied to a controversial last-second touchdown to Ben Coates and a 25–21 Patriots win.
The Bills behind Flutie finished the decade defeating the Patriots twice in 1999.
The 2000s was the most lopsided decade for the rivalry to date. On November 5, 2000 Flutie and the Bills defeated the Patriots and new head coach Bill Belichick at Foxboro Stadium 16–13 in overtime. But after this the Patriots won eighteen of the next nineteen against the Bills.
This decade also saw several notable personnel changes. Following New England's 2001 championship year, Drew Bledsoe was traded by New England to Buffalo in 2002. Lawyer Milloy was then cut after the 2003 preseason and was immediately signed by Buffalo. Doug Flutie, released by the Bills after 2000, joined the Patriots by way of the San Diego Chargers in 2005.
The Patriots assembled a five-game winning streak over the Buffalo Bills in the beginning of the decade, which was snapped when Buffalo defeated the Patriots 31–0 during the first game of the 2003 season. However, the Patriots then defeated the Bills by the same score in their next match up. That win began a 15-game winning streak for the Patriots against the Bills stretching through 2010.
The game on December 28, 2008 was noteworthy; the regular season finale, the 10–5 Patriots needed a win and help from other teams to win the AFC East, while the 7–8 Bills were wrapping up the ninth straight season without a playoff berth. Played with severe wind gusts that required stadium officials to use ropes to keep the goalposts from swaying, the game was a 13–0 Patriots win as Matt Cassel, subbing for injured Tom Brady, threw only eight passes.
The game on September 26, 2010 was noteworthy on several levels. It was the 400th career win for the Patriots franchise (regular-season and playoffs). It was the highest-scoring game in the series (38–30 Patriots win) since 1994. It was first start of the season for Buffalo's former backup quarterback Ryan Fitzpatrick. Randy Moss caught two touchdowns; they turned out to be his last with the Patriots.
On September 25, 2011, the Bills came back from a 21–0 deficit to defeat the Patriots 34–31 and snap the 15-game losing streak. Despite this win, the Patriots won the final meeting of the season, on January 1, 2012, erasing a 21–0 Bills lead to win 49–21; coming a week after erasing a 17–0 lead to Miami, it was the largest comeback win since erasing a 21-point gap against the Bears.
On September 30, 2012 the Patriots erased a 21–7 Bills lead in the third quarter by outscoring them, 45–7 on six straight touchdowns, winning 52–28. On November 11 the Bills stayed toe to toe with the Patriots; down, 37–31, the Bills were driving until Devin McCourty intercepted a Fitzpatrick pass in the endzone.
The Week 1 game of 2013 on September 8, 2013 featured the Patriots at the Bills. The Patriots narrowly defeated the Bills, 23–21, on the final drive of the game. It was the first start for Bills' rookie quarterback EJ Manuel, who threw two touchdowns in the contest. Manuel was unable to play in the Week 17 rematch in a rain-swept Gillette Stadium and was replaced by Thad Lewis. The Patriots won, 34–20, behind over 189 yards from LeGarrette Blount.
Following the passing of Ralph Wilson, the Bills were sold to Buffalo Sabres owners Terry Pegula and his wife Kim. In his first game as Bills owner the Bills team hosted the Patriots on October 12, 2014. The Bills had benched E.J. Manuel for veteran Kyle Orton, but three turnovers in the first half aided the Patriots in racing to a 37–22 win. Tom Brady threw for 361 yards - his 60th 300-yard game - and four touchdowns, including a 43-yard strike to Brian Tyms. In Week 17, the Bills won their first matchup since Gillette Stadium had been built and would be Buffalo's first regulation win in New England in over 20 years. The Patriots having clinched home field advantage throughout the playoffs with Denver falling to the Cincinnati Bengals the week prior, played Brady during the first half of the game only. The Patriots played Jimmy Garoppolo in his place in the second half but both failed to find the endzone in the 17–9 Buffalo win.
After the 2014 season, Buffalo hired former New York Jets head coach Rex Ryan. When asked if the Jets would be his focus during the 2015 season, Ryan admitted that the Patriots would still be his number one target. The Patriots traveled to Orchard Park in Week Two of the 2015 season; they raced to a 37–13 lead; the Bills scored three touchdowns in the fourth quarter behind quarterback Tyrod Taylor but a late field goal by Stephen Gostkowski and an interception of Taylor sealed a 40–32 Patriots win.
2016 saw the Patriots hosting the Bills in week 4. The Patriots faced a shortage at quarterback, as Tom Brady had been suspended the first four games of the season as a result of his involvement in the Deflategate scandal, and primary backup Jimmy Garoppolo had also been sidelined with an injury. As a result, third string quarterback Jacoby Brissett made the start for the Patriots. Unable to overcome a strong defensive showing from the Bills and an efficient performance by Tyrod Taylor, Brissett and the Patriots lost 16–0. It was the first shutout loss at home for New England since 1993, and its first ever in Gillette Stadium.Only played one game due to strike shortened season
There have been several players who have played for the Bills and Patriots, including:Doug Flutie – Buffalo Bills (1998–2000) and New England Patriots (1987–89; 2005)
Drew Bledsoe – New England Patriots (1993–2001) and Buffalo Bills (2002–04)
Lawyer Milloy – New England Patriots (1996–2002) and Buffalo Bills (2003–05)
Antowain Smith – Buffalo Bills (1997–2000) and New England Patriots (2001–03)
Fred Smerlas – Buffalo Bills (1979–89) and New England Patriots (1991–92)
Sam Gash – New England Patriots (1992–97) and Buffalo Bills (1998–99; 2003)
Larry Centers – Buffalo Bills (2001–02) and New England Patriots (2003)
Charles Johnson – New England Patriots (2001) and Buffalo Bills (2002)
Sammy Morris – Buffalo Bills (2000–03) and New England Patriots (2007–10)
Brandon Spikes – New England Patriots (2010–13) and Buffalo Bills (2014; 2016-)
Scott Chandler – Buffalo Bills (2010–14) and New England Patriots (2015)
Chris Hogan - Buffalo Bills (2012–15) and New England Patriots (2016-)
In addition to players, the two teams have shared head coaches. Lou Saban was the first coach in Patriots history but was fired after five games of the 1961 season. He took over the Bills in 1962 and won two American Football League titles (1964–65). After a five-season period in Denver he returned to the Bills for the 1972–76 period.
Hank Bullough coached both teams: He was co-head coach (with Ron Erhardt) for the Patriots at the end of 1978 and coached the Bills for the final twelve games of 1985 and the first nine games of 1986.
Pepper Johnson joined the Bills coaching staff in 2014 after fourteen seasons on the Patriots staff.