Verlander struck out Andrew Benintendi on a controversial called strike that resulted in Red Sox manager Alex Cora getting ejected in between innings.

The Astros responded in the top of the sixth with a two-out RBI single by Carlos Correa after Joe Kelly hit Alex Bregman with a pitch and Yuli Gurriel reached on a fielding error by Eduardo Núñez.

The Astros and Red Sox would trade zeroes until the top of the ninth inning which was led off by a Josh Reddick home run off of Brandon Workman.

Workman then, after getting an out, walked Jose Altuve and Alex Bregman before Yuli Gurriel hit a three-run home run to blow the game open at 7–2.

[11] Mookie Betts doubled off Gerrit Cole and Andrew Benintendi singled him home to open the scoring for the Red Sox.

Xander Bogaerts reached second on Cole's throwing error with one out in the first, then Rafael Devers singled home Benintendi for a 2–0 lead.

Craig Kimbrel pitched the ninth, allowing a two-out double by Springer and a Jose Altuve RBI single to bring the Astros to within 7–5.

Kimbrel then retired Alex Bregman, who flew out to Benintendi to end the game, earning his third save this postseason, and tying the series at one all.

Houston tied the game in the bottom of the fifth, as Jose Altuve worked a two-out walk and Alex Bregman drove him in with a double under the glove of Boston third baseman Rafael Devers.

In the bottom of the seventh, Ryan Brasier relieved Red Sox starter Eovaldi, who had allowed two runs on six hits in six innings pitched.

With two outs in the top of the eighth, Boston had the bases loaded when pinch hitter Mitch Moreland was hit by a pitch from Roberto Osuna, forcing in a run.

Former Astros player Chris Burke, who hit a series-winning home run in the 2005 NLDS, threw the ceremonial first pitch.

In the bottom of the first, a deep drive and potential two-run homer to right field by Jose Altuve, which Mookie Betts nearly caught with a leaping grab at the wall, was ruled an out due to fan interference.

In the bottom of the eighth, Alex Bregman was hit by a pitch, advanced to third on a Springer double, and scored on a ground out by Altuve, trimming Boston's lead to 8–6.

Red Sox closer Craig Kimbrel allowed three walks in the bottom of the ninth to load the bases, but got the final out on Benintendi's diving catch off a Bregman liner to left, for his fourth save this postseason.

In the top of the sixth, Mitch Moreland doubled, Ian Kinsler singled, and Rafael Devers homered into the Crawford Boxes, putting Boston ahead, 4–0.

Boston's starter from Game 3, Nathan Eovaldi, came on in relief of Barnes, getting the final out of the seventh and holding Houston scoreless in the eighth.

Boston's Jackie Bradley Jr., who had nine RBIs in the series on three hits (a double and two home runs), was named ALCS MVP.

Hinch, would receive season-long bans from MLB due to their role in the Houston Astros sign stealing scandal, which alleged the organization used a video camera in the center field seats to observe the opposing catcher as he instructed the pitcher about the next pitch during the 2017 and parts of the 2018 seasons.

[22] MLB's investigation determined that Red Sox manager Alex Cora, along with veteran player Carlos Beltrán, helped mastermind the Astros' sign-stealing while serving as Hinch's bench coach in 2017.