Halfway through the league season, Milan lead their capital-city counterparts by 10 points in the Serie A standings, with either side targeting a top-four finish.
Match preview
After beating Cagliari 4-1 in the Coppa Italia saw Milan start 2024 with a fourth straight home win, last week's league victory at Empoli then suggested they could go on to reach the cup semi-finals on Wednesday.
The Rossoneri had cruised to a 3-0 Serie A success at Stadio Carlo Castellani, with rookie forward Chaka Traore finishing off the scoring after earlier strikes from Ruben Loftus-Cheek and evergreen Olivier Giroud, which set them up perfectly to host Atalanta BC in the Coppa quarter-finals.
Although Rafael Leao put Milan in front just before half time, their Lombardy rivals responded almost immediately through Teun Koopmeiners, who then converted a second-half penalty to put La Dea into the last eight.
A two-decade drought in Italy's knockout competition therefore goes on, but Stefano Pioli's men have no time to linger on another disappointing defeat, as they sit nine points adrift of league leaders Inter Milan with half the league season to play.
Over the last seven Serie A matchdays, Milan have picked up 16 points and kept four clean sheets - only Inter and Juventus have fared better - so they may well be confident of overcoming their next visitors and keeping pressure on the top two.
Unbeaten in five home meetings with Roma, including a 2-2 draw last season, the Rossoneri's last league loss to the capital club at San Siro occurred more than six years ago.
All told, Roma are winless in their last eight Serie A matches against Milan, suffering five defeats since a 2-1 victory in October 2019.
Recent results mean that few would back them to end that streak on Sunday, as a promising run from November into early December has been halted by a series of setbacks: the Giallorossi have been beaten by Bologna and Juventus in the league and then slumped out of the Coppa Italia earlier this week.
Only the 'away' team on paper, Roma clashed with arch-rivals Lazio at Stadio Olimpico on Wednesday evening, when Mattia Zaccagni's second-half spot-kick separated the sides at their shared home in the Eternal City.
A bad-tempered encounter, marred by Edoardo Bove being struck by a beer bottle hurled from the stands and racist chanting directed towards Romelu Lukaku, ended with dismissals for substitute Sardar Azmoun and stand-in skipper Gianluca Mancini; Lazio's Pedro was also sent off against his former club.
Another defeat in the Derby della Capitale leaves the Europa League as Roma's only hope of salvaging silverware from a below-par campaign, as they sit eighth in Serie A, seemingly set to miss out on Champions League qualification once again.
Often fragile on the road, Roma have lost both of their last two away games in Serie A without scoring, and with Jose Mourinho absent from the dugout as he serves his latest suspension, they face a tough task to arrest their decline in Milan.
AC Milan Serie A form:
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AC Milan form (all competitions):
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Roma Serie A form:
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Roma form (all competitions):
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Team News
While centre-back trio Pierre Kalulu, Malick Thiaw and Fikayo Tomori all remain unavailable due to injury, Milan's defensive crisis has not deepened further, as Matteo Gabbia will recover from the ugly clash with Atalanta's Marten De Roon that saw him substituted in midweek.
Tommaso Pobega is ruled out again, though, while Alessandro Florenzi is a doubt to face his former club; Ismael Bennacer and Samu Chukwueze are away at the Africa Cup of Nations.
In better news for Stefano Pioli, Swiss striker Noah Okafor is back in full training and could feature on the bench, with December's 'Serie A Player of the Month' Christian Pulisic joining Rafael Leao and Olivier Giroud - both of whom scored in September's reverse fixture - up front.
While Giroud needs one goal to become the first Milan player to reach double figures in three straight Serie A seasons since Alexandre Pato (2008-09 to 2010-11), Roma's Romelu Lukaku will also aim to make the scoresheet, having scored in all four league games he has started against the Rossoneri.
The ex-Inter striker could be partnered by either Stephan El Shaarawy or Andrea Belotti on his return to San Siro, as Paulo Dybala suffered another muscular injury in the Rome Derby and is facing a race against time.
Jose Mourinho's other attacking option, Sardar Azmoun, has departed for the Asian Cup in Qatar: the Iran international faces a two-match ban for his red card against Lazio, while Gianluca Mancini must serve a three-match suspension, but those sanctions only apply to next year's Coppa Italia.
Like Pioli, Mourinho also has defensive issues to deal with, as Evan Ndicka is representing hosts Ivory Coast at the AFCON and Chris Smalling remains sidelined. Mancini and Diego Llorente are struggling with minor injuries, while Juventus loanee Dean Huijsen made a major mistake by conceding the decisive penalty on his debut.
AC Milan possible starting lineup:
Maignan; Calabria, Kjaer, Hernandez, Jimenez; Reijnders, Adli; Pulisic, Loftus-Cheek, Leao; Giroud
Roma possible starting lineup:
Patricio; Mancini, Cristante, Llorente; Kristensen, Pellegrini, Paredes, Bove, Zalewski; Belotti, Lukaku