With the boost of Tannehill, what was a previously bottom-tier NFL offense transformed into one of its best, helping the Titans to a strong 7–3 finish, making them 9–7 for the fourth straight year and allowing for their return to the postseason after a one-year absence.

However, the Titans' Cinderella season came to an end when they fell to the eventual Super Bowl LIV champion Kansas City Chiefs 35–24 in the AFC Championship Game.

On January 8, 2019, Titans offensive coordinator Matt LaFleur was hired as the head coach of the Green Bay Packers.

[1] On January 21, 2019, Titans tight ends coach Arthur Smith was promoted to the role of offensive coordinator.

Though favored to lose, the Titans surprised the league with a blowout win over the heavily hyped Browns in Cleveland with a strong second-half performance.

Titans QB Marcus Mariota and RB Derrick Henry had efficient games, leading the team to four touchdowns on offense to complement the strong defensive performance.

The Titans faced traditional rival Jacksonville in a Thursday night matchup for the fifth time in six years, but lost after an effective performance by Jaguars quarterback Gardner Minshew.

After an ineffective performance, Marcus Mariota was benched for backup quarterback Ryan Tannehill in the third quarter as the Titans were shut out 16–0.

Cody Parkey's field goal put the Titans within 23–20 late in the third then Ryan Tannehill led a drive ending in an A. J.

The game lead tied or changed six times and the Titans rallied to the win on two field goal miscues by the Chiefs, first on a blown snap, subsequent missed throw by Dustin Colquitt, and resulting intentional grounding penalty while Tennessee trailed 32–27, then following an Adam Humphries touchdown catch and Ryan Tannehill two-point conversion run, on a blocked Harrison Butker 52-yard attempt, the kick blocked by Joshua Kalu.

In a game with heavy playoff implications, the Titans scored three unanswered touchdowns in the second half after being locked in a 21–21 tie with the Raiders at halftime.

With the win, the Titans improved to 8–5, reaching a tie with the Pittsburgh Steelers for the sixth seed in the AFC.

New England took the opening kickoff and drove 57 yards in 8 plays, the longest a 21-yard completion from Tom Brady to tight end Benjamin Watson.

Henry then ran a screen pass 22 yards to the Patriots' 1-yard line, ultimately converting a 1-yard touchdown run to give the Titans a 14–13 halftime lead.

In the final minute of the game, Tennessee punter Brett Kern's 58-yard kick pinned the Patriots back at their own 1-yard line.

[20][21] On the Ravens' first drive of the game, Lamar Jackson threw a pass that bounced off the hands of Mark Andrews and was intercepted by safety Kevin Byard, who returned it 31 yards, with an unnecessary roughness penalty against Jackson for a horse-collar tackle adding another 15 yards and giving Tennessee a first down on the Ravens' 35-yard line.

[21] Jackson attempted to convert with a quarterback sneak, but he was tackled by linebacker David Long Jr. for no gain on the last play of the first quarter.

Then when faced with 3rd and goal from the 3-yard line, Henry took a direct snap out of wildcat formation and threw a jump pass to Corey Davis for a touchdown.

[21] This gave Tennessee a 21–6 lead and made Henry the first running back to throw a touchdown pass in the postseason since Allen Rice in the 1987 season.

[23] On the first play of the Ravens' next possession, defensive end Jurrell Casey forced a fumble while sacking Jackson,[22] which Jeffery Simmons recovered for Tennessee on the Baltimore 20-yard line.

[21] Baltimore responded with a drive to the Titans' 36-yard line, only to lose the ball again with a Jackson pass that was intercepted by safety Kenny Vaccaro.

After forcing Tennessee to punt, the Ravens finally managed to score a touchdown, moving the ball 83 yards in 10 plays, the longest a 27-yard run by Jackson.